- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,127.00 / $25,127.00 / $29,780.50
| Facility | | $25,127.00 | $25,127.00 | $29,780.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,354.90 / $29,864.41 / $44,675.34
| Facility | | $18,354.90 | $29,864.41 | $44,675.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,550.78 / $25,435.94 / $43,276.31
| Facility | | $20,550.78 | $25,435.94 | $43,276.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,386.43 / $29,501.08 / $48,289.01
| Facility | | $18,386.43 | $29,501.08 | $48,289.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $270.01 / $17,041.07 / $24,640.76
| Facility | | $270.01 | $17,041.07 | $24,640.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,922.86 / $29,145.81 / $34,253.62
| Facility | | $20,922.86 | $29,145.81 | $34,253.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,882.87 / $31,088.26 / $39,189.29
| Facility | | $18,882.87 | $31,088.26 | $39,189.29 |