- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,527.00 / $24,527.00 / $29,069.30
| Facility | | $24,527.00 | $24,527.00 | $29,069.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,287.00 / $28,126.87 / $42,076.08
| Facility | | $17,287.00 | $28,126.87 | $42,076.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,060.04 / $24,828.55 / $42,242.90
| Facility | | $20,060.04 | $24,828.55 | $42,242.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,947.38 / $28,992.66 / $47,135.90
| Facility | | $17,947.38 | $28,992.66 | $47,135.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $254.30 / $16,049.61 / $24,052.36
| Facility | | $254.30 | $16,049.61 | $24,052.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,423.24 / $28,449.83 / $33,435.68
| Facility | | $20,423.24 | $28,449.83 | $33,435.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,431.96 / $30,532.32 / $38,253.47
| Facility | | $18,431.96 | $30,532.32 | $38,253.47 |