- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,330.50 / $20,827.80 / $30,688.00
| Facility | | $15,330.50 | $20,827.80 | $30,688.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,104.58 / $22,104.58 / $24,494.24
| Facility | | $22,104.58 | $22,104.58 | $24,494.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,479.02 / $18,939.11 / $27,780.37
| Facility | | $12,479.02 | $18,939.11 | $27,780.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,373.88 / $18,463.45 / $33,418.00
| Facility | | $13,373.88 | $18,463.45 | $33,418.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $133.50 / $190.60 / $312.07
| Facility | | $133.50 | $190.60 | $312.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,730.65 / $20,386.65 / $33,551.67
| Facility | | $14,730.65 | $20,386.65 | $33,551.67 |