- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,155.00 / $30,990.00 / $50,371.70
| Facility | | $18,155.00 | $30,990.00 | $50,371.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,687.00 / $21,006.18 / $29,309.75
| Facility | | $9,687.00 | $21,006.18 | $29,309.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,567.84 / $24,623.06 / $38,845.26
| Facility | | $15,567.84 | $24,623.06 | $38,845.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,002.64 / $16,760.64 / $39,176.83
| Facility | | $7,002.64 | $16,760.64 | $39,176.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,842.00 / $25,717.42 / $35,374.83
| Facility | | $6,842.00 | $25,717.42 | $35,374.83 |