- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,587.00 / $15,212.80 / $25,438.50
| Facility | | $7,587.00 | $15,212.80 | $25,438.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,613.00 / $21,376.12 / $32,622.80
| Facility | | $1,613.00 | $21,376.12 | $32,622.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,646.00 / $20,414.71 / $32,640.98
| Facility | | $14,646.00 | $20,414.71 | $32,640.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,445.39 / $21,992.58 / $46,119.15
| Facility | | $11,445.39 | $21,992.58 | $46,119.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,439.68 / $8,439.68 / $8,439.68
| Facility | | $8,439.68 | $8,439.68 | $8,439.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,145.87 / $21,847.35 / $32,649.03
| Facility | | $16,145.87 | $21,847.35 | $32,649.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,870.00 / $16,763.00 / $28,080.19
| Facility | | $4,870.00 | $16,763.00 | $28,080.19 |