- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,574.80 / $21,228.30 / $37,355.69
| Facility | | $12,574.80 | $21,228.30 | $37,355.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,680.00 / $11,680.00 / $11,680.00
| Facility | | $11,680.00 | $11,680.00 | $11,680.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,842.06 / $21,908.34 / $36,224.21
| Facility | | $14,842.06 | $21,908.34 | $36,224.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,438.73 / $19,409.53 / $27,018.95
| Facility | | $11,438.73 | $19,409.53 | $27,018.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,450.55 / $39,450.55 / $46,298.57
| Facility | | $39,450.55 | $39,450.55 | $46,298.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $18,500.29 / $26,425.54
| Facility | | $1,787.00 | $18,500.29 | $26,425.54 |