- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,302.30 / $24,865.20 / $34,961.00
| Facility | | $18,302.30 | $24,865.20 | $34,961.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,861.08 / $20,861.08 / $20,861.08
| Facility | | $20,861.08 | $20,861.08 | $20,861.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,610.70 / $22,186.39 / $33,166.87
| Facility | | $14,610.70 | $22,186.39 | $33,166.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,966.38 / $22,042.54 / $39,896.00
| Facility | | $15,966.38 | $22,042.54 | $39,896.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $227.55 / $372.57
| Facility | | $150.00 | $227.55 | $372.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,586.16 / $24,338.55 / $40,055.58
| Facility | | $17,586.16 | $24,338.55 | $40,055.58 |