- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,003.20 / $24,458.80 / $36,612.00
| Facility | | $18,003.20 | $24,458.80 | $36,612.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,665.15 / $22,665.15 / $22,665.15
| Facility | | $22,665.15 | $22,665.15 | $22,665.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,489.07 / $21,819.40 / $32,618.25
| Facility | | $14,489.07 | $21,819.40 | $32,618.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,705.45 / $21,682.31 / $39,244.00
| Facility | | $15,705.45 | $21,682.31 | $39,244.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $223.83 / $366.48
| Facility | | $150.00 | $223.83 | $366.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,298.75 / $23,940.80 / $39,400.98
| Facility | | $17,298.75 | $23,940.80 | $39,400.98 |