- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,301.00 / $28,126.30 / $45,287.00
| Facility | | $12,301.00 | $28,126.30 | $45,287.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,001.82 / $21,001.82 / $21,001.82
| Facility | | $21,001.82 | $21,001.82 | $21,001.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $15,217.66 / $40,423.26
| Facility | | $1,474.01 | $15,217.66 | $40,423.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,359.84 / $29,407.90 / $41,659.82
| Facility | | $20,359.84 | $29,407.90 | $41,659.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,796.75 / $24,665.21 / $51,799.99
| Facility | | $17,796.75 | $24,665.21 | $51,799.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,709.30 / $24,665.21 / $52,468.83
| Facility | | $16,709.30 | $24,665.21 | $52,468.83 |