- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,012.00 / $18,802.20 / $28,510.00
| Facility | | $3,012.00 | $18,802.20 | $28,510.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,774.45 / $15,774.45 / $24,235.38
| Facility | | $15,774.45 | $15,774.45 | $24,235.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,261.74 / $17,158.02 / $25,070.50
| Facility | | $11,261.74 | $17,158.02 | $25,070.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,073.23 / $16,790.00 / $29,941.74
| Facility | | $12,073.23 | $16,790.00 | $29,941.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.00 / $176.77 / $303.60
| Facility | | $125.00 | $176.77 | $303.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,322.26 / $20,016.00 / $30,288.67
| Facility | | $14,322.26 | $20,016.00 | $30,288.67 |