- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,663.90 / $26,663.90 / $31,602.00
| Facility | | $26,663.90 | $26,663.90 | $31,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,047.95 / $30,992.04 / $46,362.20
| Facility | | $19,047.95 | $30,992.04 | $46,362.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,807.76 / $26,991.72 / $45,923.29
| Facility | | $21,807.76 | $26,991.72 | $45,923.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,511.03 / $31,305.50 / $51,242.59
| Facility | | $19,511.03 | $31,305.50 | $51,242.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $280.20 / $17,684.52 / $26,147.91
| Facility | | $280.20 | $17,684.52 | $26,147.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,202.60 / $30,928.50 / $36,348.75
| Facility | | $22,202.60 | $30,928.50 | $36,348.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,037.84 / $32,989.76 / $41,586.29
| Facility | | $20,037.84 | $32,989.76 | $41,586.29 |