- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,580.23 / $20,977.30 / $35,418.10
| Facility | | $9,580.23 | $20,977.30 | $35,418.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,494.29 / $32,693.80 / $42,025.25
| Facility | | $21,494.29 | $32,693.80 | $42,025.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,500.00 / $3,500.00 / $3,500.00
| Facility | | $3,500.00 | $3,500.00 | $3,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,912.09 / $29,903.48 / $43,896.64
| Facility | | $20,912.09 | $29,903.48 | $43,896.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,388.32 / $29,569.04 / $62,007.20
| Facility | | $15,388.32 | $29,569.04 | $62,007.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,912.09 / $32,557.73 / $44,138.64
| Facility | | $20,912.09 | $32,557.73 | $44,138.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,058.53 / $27,535.48 / $41,394.72
| Facility | | $6,058.53 | $27,535.48 | $41,394.72 |