- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,041.50 / $17,454.40 / $28,303.20
| Facility | | $11,041.50 | $17,454.40 | $28,303.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,416.70 / $42,416.70 / $42,416.70
| Facility | | $42,416.70 | $42,416.70 | $42,416.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,606.65 / $15,415.62 / $35,486.69
| Facility | | $12,606.65 | $15,415.62 | $35,486.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $12,166.11 / $27,328.30
| Facility | | $100.00 | $12,166.11 | $27,328.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,068.90 / $18,320.00 / $32,136.94
| Facility | | $12,068.90 | $18,320.00 | $32,136.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,857.52 / $24,478.05 / $28,727.07
| Facility | | $16,857.52 | $24,478.05 | $28,727.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,137.04 / $15,386.05 / $32,417.24
| Facility | | $11,137.04 | $15,386.05 | $32,417.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,717.00 / $14,184.26 / $27,966.40
| Facility | | $5,717.00 | $14,184.26 | $27,966.40 |