- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,180.00 / $23,200.50 / $28,014.00
| Facility | | $12,180.00 | $23,200.50 | $28,014.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $20,949.59 / $35,960.23
| Facility | | $6,916.00 | $20,949.59 | $35,960.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,930.87 / $19,675.75 / $23,758.16
| Facility | | $16,930.87 | $19,675.75 | $23,758.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,914.08 / $17,089.74 / $22,509.88
| Facility | | $10,914.08 | $17,089.74 | $22,509.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,840.02 / $21,343.12 / $33,216.73
| Facility | | $12,840.02 | $21,343.12 | $33,216.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,199.32 / $19,328.40 / $24,454.94
| Facility | | $14,199.32 | $19,328.40 | $24,454.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $19,102.14 / $27,517.06
| Facility | | $3,775.00 | $19,102.14 | $27,517.06 |