- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,899.90 / $21,777.10 / $38,321.40
| Facility | | $12,899.90 | $21,777.10 | $38,321.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,512.00 / $10,512.00 / $12,236.76
| Facility | | $10,512.00 | $10,512.00 | $12,236.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,109.21 / $25,108.77 / $41,536.80
| Facility | | $17,109.21 | $25,108.77 | $41,536.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,734.45 / $19,865.00 / $27,717.45
| Facility | | $11,734.45 | $19,865.00 | $27,717.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41,583.80 / $41,583.80 / $48,802.12
| Facility | | $41,583.80 | $41,583.80 | $48,802.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $18,978.56 / $27,108.70
| Facility | | $1,787.00 | $18,978.56 | $27,108.70 |