- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,677.03 / $17,993.00 / $23,492.40
| Facility | | $8,677.03 | $17,993.00 | $23,492.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,219.11 / $43,999.90
| Facility | | $5,840.42 | $16,219.11 | $43,999.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,166.67 / $16,810.81 / $25,401.33
| Facility | | $10,166.67 | $16,810.81 | $25,401.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,873.07 / $23,873.07 / $23,873.07
| Facility | | $23,873.07 | $23,873.07 | $23,873.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,648.18 / $16,935.37 / $26,152.19
| Facility | | $14,648.18 | $16,935.37 | $26,152.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,219.11 / $43,999.90
| Facility | | $5,840.42 | $16,219.11 | $43,999.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,778.52 / $34,386.31
| Facility | | $5,840.42 | $12,778.52 | $34,386.31 |