- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,331.70 / $24,768.00 / $34,272.50
| Facility | | $15,331.70 | $24,768.00 | $34,272.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,473.83 / $25,473.83 / $25,473.83
| Facility | | $25,473.83 | $25,473.83 | $25,473.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,756.78 / $22,043.29 / $33,396.05
| Facility | | $13,756.78 | $22,043.29 | $33,396.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,516.00 / $20,721.64 / $35,474.33
| Facility | | $7,516.00 | $20,721.64 | $35,474.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,516.00 / $20,170.58 / $31,490.95
| Facility | | $7,516.00 | $20,170.58 | $31,490.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,403.00 / $26,666.10 / $38,094.93
| Facility | | $10,403.00 | $26,666.10 | $38,094.93 |