- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,726.00 / $22,067.80 / $30,725.00
| Facility | | $15,726.00 | $22,067.80 | $30,725.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,205.28 / $19,205.28 / $19,205.28
| Facility | | $19,205.28 | $19,205.28 | $19,205.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,800.15 / $19,422.00 / $28,495.25
| Facility | | $12,800.15 | $19,422.00 | $28,495.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,718.86 / $18,939.70 / $34,280.00
| Facility | | $13,718.86 | $18,939.70 | $34,280.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136.94 / $195.52 / $320.12
| Facility | | $136.94 | $195.52 | $320.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,337.61 / $20,885.09 / $33,152.19
| Facility | | $14,337.61 | $20,885.09 | $33,152.19 |