- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,617.50 / $17,942.50 / $48,818.00
| Facility | | $11,617.50 | $17,942.50 | $48,818.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,111.15 / $12,111.15 / $18,035.62
| Facility | | $12,111.15 | $12,111.15 | $18,035.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,922.08 / $16,642.11 / $28,973.00
| Facility | | $10,922.08 | $16,642.11 | $28,973.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,600.00 / $18,303.63 / $27,489.47
| Facility | | $13,600.00 | $18,303.63 | $27,489.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,604.37 / $19,193.38 / $36,434.00
| Facility | | $9,604.37 | $19,193.38 | $36,434.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,604.37 / $18,365.09 / $33,208.08
| Facility | | $9,604.37 | $18,365.09 | $33,208.08 |