- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,520.00 / $14,646.00 / $25,373.10
| Facility | | $7,520.00 | $14,646.00 | $25,373.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,717.98 / $24,808.33 / $32,168.77
| Facility | | $16,717.98 | $24,808.33 | $32,168.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,646.00 / $20,362.28 / $32,557.14
| Facility | | $14,646.00 | $20,362.28 | $32,557.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,415.99 / $21,936.10 / $46,000.69
| Facility | | $11,415.99 | $21,936.10 | $46,000.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,575.86 / $8,575.86 / $8,575.86
| Facility | | $8,575.86 | $8,575.86 | $8,575.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,104.40 / $21,791.24 / $32,565.18
| Facility | | $16,104.40 | $21,791.24 | $32,565.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,870.00 / $16,763.00 / $28,008.07
| Facility | | $4,870.00 | $16,763.00 | $28,008.07 |