- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,930.80 / $24,993.30 / $40,242.40
| Facility | | $10,930.80 | $24,993.30 | $40,242.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,684.18 / $30,684.18 / $30,684.18
| Facility | | $30,684.18 | $30,684.18 | $30,684.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $16,452.30 / $34,630.08
| Facility | | $1,474.01 | $16,452.30 | $34,630.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,006.00 / $24,752.25 / $37,019.26
| Facility | | $17,006.00 | $24,752.25 | $37,019.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,814.34 / $21,917.72 / $46,029.92
| Facility | | $15,814.34 | $21,917.72 | $46,029.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,814.34 / $26,740.99 / $39,515.07
| Facility | | $15,814.34 | $26,740.99 | $39,515.07 |