- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,850.00 / $24,476.70 / $29,555.00
| Facility | | $12,850.00 | $24,476.70 | $29,555.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $22,102.00 / $37,938.33
| Facility | | $6,916.00 | $22,102.00 | $37,938.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,317.75 / $20,691.00 / $25,028.86
| Facility | | $18,317.75 | $20,691.00 | $25,028.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,370.28 / $17,768.40 / $23,419.37
| Facility | | $12,370.28 | $17,768.40 | $23,419.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,352.02 / $23,074.58 / $35,283.60
| Facility | | $13,352.02 | $23,074.58 | $35,283.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,773.03 / $20,743.78 / $26,971.26
| Facility | | $14,773.03 | $20,743.78 | $26,971.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $20,152.91 / $29,030.72
| Facility | | $3,775.00 | $20,152.91 | $29,030.72 |