- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,020.00 / $24,800.50 / $29,946.00
| Facility | | $13,020.00 | $24,800.50 | $29,946.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $22,394.40 / $35,126.35
| Facility | | $6,916.00 | $22,394.40 | $35,126.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,717.40 / $20,844.91 / $25,351.26
| Facility | | $17,717.40 | $20,844.91 | $25,351.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,963.35 / $16,931.82 / $21,931.80
| Facility | | $10,963.35 | $16,931.82 | $21,931.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,064.56 / $21,535.50 / $33,609.18
| Facility | | $12,064.56 | $21,535.50 | $33,609.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,320.66 / $18,704.40 / $25,784.92
| Facility | | $13,320.66 | $18,704.40 | $25,784.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $21,880.89 / $29,414.78
| Facility | | $3,775.00 | $21,880.89 | $29,414.78 |