- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,360.00 / $22,360.00 / $26,501.00
| Facility | | $22,360.00 | $22,360.00 | $26,501.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,887.08 / $27,476.18 / $41,102.69
| Facility | | $16,887.08 | $27,476.18 | $41,102.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,287.73 / $22,634.93 / $38,510.71
| Facility | | $18,287.73 | $22,634.93 | $38,510.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,361.71 / $26,252.41 / $42,971.41
| Facility | | $16,361.71 | $26,252.41 | $42,971.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $248.42 / $15,678.31 / $22,400.54
| Facility | | $248.42 | $15,678.31 | $22,400.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,618.83 / $25,936.26 / $30,481.61
| Facility | | $18,618.83 | $25,936.26 | $30,481.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,803.49 / $27,664.82 / $34,873.75
| Facility | | $16,803.49 | $27,664.82 | $34,873.75 |