- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,755.60 / $24,969.10 / $41,454.69
| Facility | | $15,755.60 | $24,969.10 | $41,454.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,193.82 / $22,193.82 / $22,193.82
| Facility | | $22,193.82 | $22,193.82 | $22,193.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,239.66 / $21,331.86 / $36,136.61
| Facility | | $14,239.66 | $21,331.86 | $36,136.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,473.65 / $25,907.00 / $36,929.00
| Facility | | $20,473.65 | $25,907.00 | $36,929.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,867.75 / $25,583.51 / $63,674.14
| Facility | | $12,867.75 | $25,583.51 | $63,674.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,867.75 / $25,527.85 / $35,878.12
| Facility | | $12,867.75 | $25,527.85 | $35,878.12 |