- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,974.50 / $24,547.80 / $40,422.50
| Facility | | $18,974.50 | $24,547.80 | $40,422.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,709.14 / $30,709.14 / $30,709.14
| Facility | | $30,709.14 | $30,709.14 | $30,709.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,840.33 / $21,594.24 / $43,554.29
| Facility | | $14,840.33 | $21,594.24 | $43,554.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,986.72 / $26,614.35 / $39,990.00
| Facility | | $20,986.72 | $26,614.35 | $39,990.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,547.36 / $26,071.63 / $63,077.02
| Facility | | $12,547.36 | $26,071.63 | $63,077.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,547.36 / $24,892.25 / $34,984.82
| Facility | | $12,547.36 | $24,892.25 | $34,984.82 |