- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,960.00 / $26,591.00 / $32,108.00
| Facility | | $13,960.00 | $26,591.00 | $32,108.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $24,011.20 / $43,509.95
| Facility | | $12,397.00 | $24,011.20 | $43,509.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,811.46 / $22,930.55 / $25,610.06
| Facility | | $19,811.46 | $22,930.55 | $25,610.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,752.23 / $21,505.50 / $28,560.40
| Facility | | $14,752.23 | $21,505.50 | $28,560.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,561.58 / $26,873.28 / $41,215.50
| Facility | | $15,561.58 | $26,873.28 | $41,215.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,244.72 / $23,901.12 / $32,927.73
| Facility | | $17,244.72 | $23,901.12 | $32,927.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $23,460.62 / $33,755.28
| Facility | | $3,775.00 | $23,460.62 | $33,755.28 |