- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,487.00 / $16,941.50 / $23,442.60
| Facility | | $10,487.00 | $16,941.50 | $23,442.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,143.40 / $38,143.40 / $38,143.40
| Facility | | $38,143.40 | $38,143.40 | $38,143.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,472.75 / $15,178.73 / $22,996.11
| Facility | | $9,472.75 | $15,178.73 | $22,996.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,362.68 / $14,173.73 / $24,264.65
| Facility | | $7,362.68 | $14,173.73 | $24,264.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,362.68 / $13,997.83 / $21,540.00
| Facility | | $7,362.68 | $13,997.83 | $21,540.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,915.51 / $18,532.93 / $26,621.96
| Facility | | $7,915.51 | $18,532.93 | $26,621.96 |