- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,931.00 / $35,379.19 / $58,737.90
| Facility | | $22,931.00 | $35,379.19 | $58,737.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,352.65 / $22,352.65 / $22,352.65
| Facility | | $22,352.65 | $22,352.65 | $22,352.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,102.00 / $33,687.22 / $57,692.55
| Facility | | $11,102.00 | $33,687.22 | $57,692.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,764.00 / $36,034.42 / $59,188.00
| Facility | | $10,764.00 | $36,034.42 | $59,188.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,232.57 / $37,077.83 / $57,633.83
| Facility | | $18,232.57 | $37,077.83 | $57,633.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,850.00 / $37,077.83 / $50,836.43
| Facility | | $17,850.00 | $37,077.83 | $50,836.43 |