- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,931.50 / $25,931.50 / $30,734.00
| Facility | | $25,931.50 | $25,931.50 | $30,734.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,900.50 / $29,125.07 / $43,569.33
| Facility | | $17,900.50 | $29,125.07 | $43,569.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,208.79 / $26,250.37 / $44,661.96
| Facility | | $21,208.79 | $26,250.37 | $44,661.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,975.14 / $30,445.66 / $49,835.16
| Facility | | $18,975.14 | $30,445.66 | $49,835.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.32 / $16,619.20 / $25,429.73
| Facility | | $263.32 | $16,619.20 | $25,429.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,592.78 / $30,079.02 / $35,350.39
| Facility | | $21,592.78 | $30,079.02 | $35,350.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,487.48 / $32,083.67 / $40,444.08
| Facility | | $19,487.48 | $32,083.67 | $40,444.08 |