- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,131.70 / $25,992.00 / $39,337.00
| Facility | | $19,131.70 | $25,992.00 | $39,337.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,712.01 / $33,712.01 / $33,712.01
| Facility | | $33,712.01 | $33,712.01 | $33,712.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,116.01 / $23,187.28 / $34,663.12
| Facility | | $15,116.01 | $23,187.28 | $34,663.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,689.93 / $23,041.46 / $41,704.00
| Facility | | $16,689.93 | $23,041.46 | $41,704.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $244.36 / $389.45
| Facility | | $150.00 | $244.36 | $389.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,383.12 / $25,441.53 / $41,870.82
| Facility | | $18,383.12 | $25,441.53 | $41,870.82 |