- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,120.00 / $28,800.60 / $34,776.00
| Facility | | $15,120.00 | $28,800.60 | $34,776.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $26,006.40 / $44,640.29
| Facility | | $6,916.00 | $26,006.40 | $44,640.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,372.40 / $24,224.06 / $28,949.38
| Facility | | $21,372.40 | $24,224.06 | $28,949.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,146.14 / $20,529.20 / $27,123.55
| Facility | | $14,146.14 | $20,529.20 | $27,123.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,438.54 / $26,006.40 / $40,024.90
| Facility | | $15,438.54 | $26,006.40 | $40,024.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,109.65 / $23,175.12 / $29,834.33
| Facility | | $17,109.65 | $23,175.12 | $29,834.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $25,410.07 / $34,159.10
| Facility | | $3,775.00 | $25,410.07 | $34,159.10 |