- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,916.77 / $18,501.20 / $24,817.80
| Facility | | $8,916.77 | $18,501.20 | $24,817.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,162.56 / $18,599.00 / $26,191.08
| Facility | | $16,162.56 | $18,599.00 | $26,191.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $18,858.75 / $22,423.93
| Facility | | $2,651.00 | $18,858.75 | $22,423.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,726.02 / $19,104.50 / $30,069.90
| Facility | | $15,726.02 | $19,104.50 | $30,069.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $23,603.11
| Facility | | $1,350.00 | $5,713.00 | $23,603.11 |