- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,720.66 / $18,083.50 / $23,610.60
| Facility | | $8,720.66 | $18,083.50 | $23,610.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,503.00 / $16,300.67 / $44,221.16
| Facility | | $2,503.00 | $16,300.67 | $44,221.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,217.79 / $16,895.34 / $25,529.06
| Facility | | $10,217.79 | $16,895.34 | $25,529.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,819.83 / $21,819.83 / $21,819.83
| Facility | | $21,819.83 | $21,819.83 | $21,819.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,721.84 / $17,020.53 / $26,283.70
| Facility | | $14,721.84 | $17,020.53 | $26,283.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,503.00 / $16,300.67 / $44,221.16
| Facility | | $2,503.00 | $16,300.67 | $44,221.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,503.00 / $16,300.67 / $34,559.23
| Facility | | $2,503.00 | $16,300.67 | $34,559.23 |