- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,991.10 / $23,910.50 / $42,106.40
| Facility | | $14,991.10 | $23,910.50 | $42,106.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,404.08 / $16,404.08 / $16,404.08
| Facility | | $16,404.08 | $16,404.08 | $16,404.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,746.00 / $19,960.57 / $29,016.94
| Facility | | $6,746.00 | $19,960.57 | $29,016.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,861.71 / $18,591.68 / $31,145.40
| Facility | | $13,861.71 | $18,591.68 | $31,145.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,762.85 / $15,689.86 / $19,308.43
| Facility | | $10,762.85 | $15,689.86 | $19,308.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,600.00 / $17,963.37 / $27,155.81
| Facility | | $6,600.00 | $17,963.37 | $27,155.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,721.58 / $19,300.75 / $26,214.94
| Facility | | $13,721.58 | $19,300.75 | $26,214.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $14,976.63 / $39,014.53
| Facility | | $3,775.00 | $14,976.63 | $39,014.53 |