- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,622.59 / $27,535.80 / $39,440.00
| Facility | | $19,622.59 | $27,535.80 | $39,440.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,336.45 / $31,336.45 / $31,336.45
| Facility | | $31,336.45 | $31,336.45 | $31,336.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,268.50 / $23,775.01 / $35,464.62
| Facility | | $15,268.50 | $23,775.01 | $35,464.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,118.15 / $23,632.64 / $42,774.00
| Facility | | $17,118.15 | $23,632.64 | $42,774.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $243.96 / $399.44
| Facility | | $150.00 | $243.96 | $399.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,854.78 / $26,094.28 / $42,945.10
| Facility | | $18,854.78 | $26,094.28 | $42,945.10 |