- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,697.00 / $18,402.20 / $30,003.50
| Facility | | $8,697.00 | $18,402.20 | $30,003.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,735.93 / $30,724.65 / $41,394.83
| Facility | | $20,735.93 | $30,724.65 | $41,394.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,648.00 / $24,078.19 / $38,498.49
| Facility | | $14,648.00 | $24,078.19 | $38,498.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,499.29 / $25,939.22 / $54,395.36
| Facility | | $13,499.29 | $25,939.22 | $54,395.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,646.00 / $25,767.92 / $38,508.00
| Facility | | $17,646.00 | $25,767.92 | $38,508.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $17,850.84 / $33,119.26
| Facility | | $5,281.00 | $17,850.84 | $33,119.26 |