- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,046.41 / $18,759.00 / $24,492.50
| Facility | | $9,046.41 | $18,759.00 | $24,492.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,503.00 / $13,322.50 / $45,872.97
| Facility | | $2,503.00 | $13,322.50 | $45,872.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,599.46 / $17,526.43 / $26,482.66
| Facility | | $10,599.46 | $17,526.43 | $26,482.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,889.35 / $24,889.35 / $24,889.35
| Facility | | $24,889.35 | $24,889.35 | $24,889.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,271.75 / $17,656.31 / $27,265.49
| Facility | | $15,271.75 | $17,656.31 | $27,265.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,503.00 / $13,322.50 / $45,872.97
| Facility | | $2,503.00 | $13,322.50 | $45,872.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,503.00 / $12,181.33 / $35,850.12
| Facility | | $2,503.00 | $12,181.33 | $35,850.12 |