- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,306.00 / $26,306.00 / $31,177.80
| Facility | | $26,306.00 | $26,306.00 | $31,177.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,950.62 / $29,206.62 / $43,691.33
| Facility | | $17,950.62 | $29,206.62 | $43,691.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,515.04 / $26,629.42 / $45,306.87
| Facility | | $21,515.04 | $26,629.42 | $45,306.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,249.14 / $30,885.29 / $50,554.77
| Facility | | $19,249.14 | $30,885.29 | $50,554.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $264.06 / $16,665.73 / $25,796.93
| Facility | | $264.06 | $16,665.73 | $25,796.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,904.58 / $30,513.35 / $35,860.83
| Facility | | $21,904.58 | $30,513.35 | $35,860.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,768.87 / $32,546.95 / $41,028.08
| Facility | | $19,768.87 | $32,546.95 | $41,028.08 |