- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,757.00 / $17,556.00 / $27,810.50
| Facility | | $8,757.00 | $17,556.00 | $27,810.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,727.53 / $29,274.29 / $37,959.75
| Facility | | $19,727.53 | $29,274.29 | $37,959.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,648.00 / $22,318.26 / $35,684.55
| Facility | | $14,648.00 | $22,318.26 | $35,684.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,512.60 / $24,043.26 / $50,419.48
| Facility | | $12,512.60 | $24,043.26 | $50,419.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,646.00 / $23,884.49 / $35,693.36
| Facility | | $17,646.00 | $23,884.49 | $35,693.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,926.33 / $16,780.06 / $30,698.50
| Facility | | $4,926.33 | $16,780.06 | $30,698.50 |