- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,881.25 / $23,024.00 / $30,061.10
| Facility | | $1,881.25 | $23,024.00 | $30,061.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,606.00 / $7,170.00 / $24,737.56
| Facility | | $1,606.00 | $7,170.00 | $24,737.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,508.99 / $13,993.01 / $32,915.51
| Facility | | $12,508.99 | $13,993.01 | $32,915.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,548.18 / $30,548.18 / $30,548.18
| Facility | | $30,548.18 | $30,548.18 | $30,548.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,743.93 / $21,670.64 / $33,464.56
| Facility | | $18,743.93 | $21,670.64 | $33,464.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,606.00 / $7,170.00 / $24,737.56
| Facility | | $1,606.00 | $7,170.00 | $24,737.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,606.00 / $5,840.42 / $21,322.33
| Facility | | $1,606.00 | $5,840.42 | $21,322.33 |