- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,505.00 / $15,032.16 / $28,761.50
| Facility | | $12,505.00 | $15,032.16 | $28,761.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $21,508.60 / $35,552.30
| Facility | | $12,397.00 | $21,508.60 | $35,552.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,272.71 / $20,054.75 / $23,904.42
| Facility | | $17,272.71 | $20,054.75 | $23,904.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,626.00 / $15,508.43 / $59,999.40
| Facility | | $8,626.00 | $15,508.43 | $59,999.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $20,913.90 / $33,362.65
| Facility | | $12,397.00 | $20,913.90 | $33,362.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,482.19 / $18,686.25 / $22,981.30
| Facility | | $13,482.19 | $18,686.25 | $22,981.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $14,040.00 / $26,832.73
| Facility | | $3,775.00 | $14,040.00 | $26,832.73 |