- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,000.00 / $29,029.23 / $38,103.10
| Facility | | $26,000.00 | $29,029.23 | $38,103.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,507.37 / $36,388.00 / $58,641.84
| Facility | | $26,507.37 | $36,388.00 | $58,641.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,000.00 / $31,638.60 / $34,724.37
| Facility | | $20,000.00 | $31,638.60 | $34,724.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,227.21 / $29,610.90 / $38,779.40
| Facility | | $20,227.21 | $29,610.90 | $38,779.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,000.00 / $34,049.12 / $54,343.70
| Facility | | $21,000.00 | $34,049.12 | $54,343.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,238.23 / $29,983.53 / $38,760.03
| Facility | | $22,238.23 | $29,983.53 | $38,760.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,750.00 / $35,565.07 / $43,368.13
| Facility | | $25,750.00 | $35,565.07 | $43,368.13 |