- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,706.00 / $28,706.00 / $34,022.30
| Facility | | $28,706.00 | $28,706.00 | $34,022.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,889.59 / $29,107.34 / $43,542.80
| Facility | | $17,889.59 | $29,107.34 | $43,542.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,478.00 / $29,058.99 / $49,440.51
| Facility | | $23,478.00 | $29,058.99 | $49,440.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,005.36 / $33,703.16 / $55,167.21
| Facility | | $21,005.36 | $33,703.16 | $55,167.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.16 / $16,609.08 / $26,316.45
| Facility | | $263.16 | $16,609.08 | $26,316.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,903.07 / $33,297.29 / $39,132.66
| Facility | | $23,903.07 | $33,297.29 | $39,132.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,572.52 / $35,516.42 / $44,771.34
| Facility | | $21,572.52 | $35,516.42 | $44,771.34 |