- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $20,417.38 / $40,738.03
| Facility | | $8,317.64 | $20,417.38 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $16,595.87 / $21,379.62
| Facility | | $15,135.61 | $16,595.87 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $23,988.33 / $40,738.03
| Facility | | $13,803.84 | $23,988.33 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $15,488.17 / $33,884.42
| Facility | | $100.00 | $15,488.17 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $19,498.45 / $34,673.69
| Facility | | $12,882.50 | $19,498.45 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,673.69 / $34,673.69 / $34,673.69
| Facility | | $34,673.69 | $34,673.69 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $21,379.62 / $38,904.51
| Facility | | $13,489.63 | $21,379.62 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $19,054.61 / $38,018.94
| Facility | | $5,754.40 | $19,054.61 | $38,018.94 |