- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,120.00 / $5,482.00 / $22,812.40
| Facility | | $2,120.00 | $5,482.00 | $22,812.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,326.08 / $36,326.08 / $36,326.08
| Facility | | $36,326.08 | $36,326.08 | $36,326.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,025.12 / $18,256.08 / $32,804.39
| Facility | | $10,025.12 | $18,256.08 | $32,804.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,237.13 / $25,203.18 / $39,473.41
| Facility | | $14,237.13 | $25,203.18 | $39,473.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,142.29 / $34,081.15 / $44,004.47
| Facility | | $19,142.29 | $34,081.15 | $44,004.47 |