- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,418.00 / $33,486.00 / $48,224.50
| Facility | | $16,418.00 | $33,486.00 | $48,224.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,019.50 / $22,006.44 / $29,854.36
| Facility | | $7,019.50 | $22,006.44 | $29,854.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,890.96 / $17,552.22 / $28,824.44
| Facility | | $11,890.96 | $17,552.22 | $28,824.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,766.89 / $24,841.72 / $34,085.05
| Facility | | $14,766.89 | $24,841.72 | $34,085.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51,995.65 / $51,995.65 / $61,021.31
| Facility | | $51,995.65 | $51,995.65 | $61,021.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $23,883.04 / $34,114.19
| Facility | | $1,787.00 | $23,883.04 | $34,114.19 |