- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,680.00 / $26,057.70 / $31,464.00
| Facility | | $13,680.00 | $26,057.70 | $31,464.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $23,529.60 / $39,822.83
| Facility | | $6,916.00 | $23,529.60 | $39,822.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,708.98 / $21,917.02 / $26,603.00
| Facility | | $18,708.98 | $21,917.02 | $26,603.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,122.81 / $18,317.50 / $23,940.34
| Facility | | $12,122.81 | $18,317.50 | $23,940.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,645.30 / $23,396.26 / $35,627.04
| Facility | | $13,645.30 | $23,396.26 | $35,627.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,101.66 / $20,930.84 / $27,233.79
| Facility | | $15,101.66 | $20,930.84 | $27,233.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $21,454.62 / $30,905.86
| Facility | | $3,775.00 | $21,454.62 | $30,905.86 |