- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,386.00 / $24,520.00 / $34,717.60
| Facility | | $13,386.00 | $24,520.00 | $34,717.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,265.59 / $26,380.12 / $42,428.12
| Facility | | $16,265.59 | $26,380.12 | $42,428.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,917.42 / $22,057.00 / $39,242.91
| Facility | | $13,917.42 | $22,057.00 | $39,242.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $20,810.75 / $46,404.81
| Facility | | $7,117.00 | $20,810.75 | $46,404.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $20,357.39 / $41,237.74
| Facility | | $3,308.00 | $20,357.39 | $41,237.74 |