- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,762.50 / $24,310.00 / $29,353.80
| Facility | | $12,762.50 | $24,310.00 | $29,353.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $21,951.50 / $37,680.01
| Facility | | $6,916.00 | $21,951.50 | $37,680.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,200.02 / $20,486.50 / $24,862.92
| Facility | | $18,200.02 | $20,486.50 | $24,862.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,133.12 / $17,498.09 / $22,721.80
| Facility | | $12,133.12 | $17,498.09 | $22,721.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,960.55 / $22,335.81 / $33,529.44
| Facility | | $12,960.55 | $22,335.81 | $33,529.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,333.00 / $19,960.05 / $25,212.81
| Facility | | $14,333.00 | $19,960.05 | $25,212.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $20,015.68 / $28,833.04
| Facility | | $3,775.00 | $20,015.68 | $28,833.04 |