- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,923.50 / $25,591.50 / $44,724.00
| Facility | | $19,923.50 | $25,591.50 | $44,724.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,086.45 / $8,086.45 / $8,086.45
| Facility | | $8,086.45 | $8,086.45 | $8,086.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,850.44 / $24,264.51 / $41,010.60
| Facility | | $15,850.44 | $24,264.51 | $41,010.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,982.00 / $27,945.45 / $48,807.00
| Facility | | $20,982.00 | $27,945.45 | $48,807.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,174.91 / $26,194.20 / $70,876.89
| Facility | | $13,174.91 | $26,194.20 | $70,876.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,174.91 / $26,137.22 / $36,734.57
| Facility | | $13,174.91 | $26,137.22 | $36,734.57 |