- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,324.00 / $27,900.30 / $38,596.69
| Facility | | $8,324.00 | $27,900.30 | $38,596.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $17,930.66
| Facility | | $1,146.00 | $3,000.00 | $17,930.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,501.28 / $14,509.56 / $26,913.16
| Facility | | $10,501.28 | $14,509.56 | $26,913.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,501.28 / $14,983.20 / $26,913.16
| Facility | | $10,501.28 | $14,983.20 | $26,913.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $18,570.84 / $28,794.38
| Facility | | $5,419.00 | $18,570.84 | $28,794.38 |