- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,916.60 / $23,791.60 / $41,897.00
| Facility | | $14,916.60 | $23,791.60 | $41,897.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,600.00 / $20,294.71 / $29,700.50
| Facility | | $6,600.00 | $20,294.71 | $29,700.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,792.78 / $18,499.23 / $30,990.53
| Facility | | $13,792.78 | $18,499.23 | $30,990.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,955.65 / $14,467.20 / $18,946.82
| Facility | | $8,955.65 | $14,467.20 | $18,946.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $17,788.83 / $28,246.04
| Facility | | $6,409.00 | $17,788.83 | $28,246.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,272.46 / $19,991.93 / $27,180.13
| Facility | | $14,272.46 | $19,991.93 | $27,180.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $14,902.16 / $38,820.53
| Facility | | $3,775.00 | $14,902.16 | $38,820.53 |