- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,630.01 / $22,019.00 / $35,453.40
| Facility | | $9,630.01 | $22,019.00 | $35,453.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,591.11 / $16,591.11 / $16,591.11
| Facility | | $16,591.11 | $16,591.11 | $16,591.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $11,775.29 / $30,963.12
| Facility | | $1,474.01 | $11,775.29 | $30,963.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,938.94 / $23,022.31 / $32,613.87
| Facility | | $15,938.94 | $23,022.31 | $32,613.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,932.39 / $19,309.45 / $40,552.22
| Facility | | $13,932.39 | $19,309.45 | $40,552.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,081.07 / $19,309.45 / $41,075.83
| Facility | | $13,081.07 | $19,309.45 | $41,075.83 |