- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,669.30 / $17,481.59 / $29,258.00
| Facility | | $12,669.30 | $17,481.59 | $29,258.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,607.36 / $18,607.36 / $19,899.63
| Facility | | $18,607.36 | $18,607.36 | $19,899.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $19,612.53 / $30,323.87
| Facility | | $2,423.00 | $19,612.53 | $30,323.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,966.93 / $19,667.58 / $32,982.41
| Facility | | $12,966.93 | $19,667.58 | $32,982.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $15,872.82 / $35,295.06
| Facility | | $2,600.00 | $15,872.82 | $35,295.06 |