- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,010.50 / $21,679.80 / $49,596.00
| Facility | | $11,010.50 | $21,679.80 | $49,596.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,369.70 / $27,369.70 / $27,369.70
| Facility | | $27,369.70 | $27,369.70 | $27,369.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,157.61 / $20,727.34 / $35,042.33
| Facility | | $14,157.61 | $20,727.34 | $35,042.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,681.99 / $19,784.22 / $27,593.55
| Facility | | $11,681.99 | $19,784.22 | $27,593.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,556.55 / $39,556.55 / $83,000.00
| Facility | | $39,556.55 | $39,556.55 | $83,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,158.00 / $20,057.00 / $39,554.66
| Facility | | $3,158.00 | $20,057.00 | $39,554.66 |