- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,854.00 / $24,745.80 / $33,916.00
| Facility | | $13,854.00 | $24,745.80 | $33,916.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,155.50 / $31,155.50 / $31,155.50
| Facility | | $31,155.50 | $31,155.50 | $31,155.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,459.92 / $8,459.92 / $8,639.91
| Facility | | $8,459.92 | $8,459.92 | $8,639.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,247.03 / $23,158.08 / $33,674.57
| Facility | | $13,247.03 | $23,158.08 | $33,674.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,941.10 / $24,941.10 / $30,285.62
| Facility | | $24,941.10 | $24,941.10 | $30,285.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,644.16 / $27,804.63 / $50,664.55
| Facility | | $18,644.16 | $27,804.63 | $50,664.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,649.60 / $24,745.80 / $33,792.60
| Facility | | $13,649.60 | $24,745.80 | $33,792.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,464.50 / $22,143.97 / $31,898.26
| Facility | | $12,464.50 | $22,143.97 | $31,898.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,039.75 / $20,840.75 / $34,606.94
| Facility | | $7,039.75 | $20,840.75 | $34,606.94 |