- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,406.00 / $24,056.40 / $38,733.90
| Facility | | $3,406.00 | $24,056.40 | $38,733.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,373.03 / $28,373.03 / $28,373.03
| Facility | | $28,373.03 | $28,373.03 | $28,373.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $12,515.35 / $32,376.57
| Facility | | $1,474.01 | $12,515.35 | $32,376.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,216.72 / $23,824.38 / $35,631.56
| Facility | | $16,216.72 | $23,824.38 | $35,631.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,291.43 / $21,096.11 / $44,304.43
| Facility | | $14,291.43 | $21,096.11 | $44,304.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,291.43 / $25,738.57 / $38,033.80
| Facility | | $14,291.43 | $25,738.57 | $38,033.80 |