- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,297.00 / $19,071.20 / $33,559.80
| Facility | | $11,297.00 | $19,071.20 | $33,559.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,135.48 / $16,437.06 / $27,177.76
| Facility | | $11,135.48 | $16,437.06 | $27,177.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,276.37 / $17,578.98 / $24,273.42
| Facility | | $10,276.37 | $17,578.98 | $24,273.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,383.55 / $37,383.55 / $43,872.77
| Facility | | $37,383.55 | $37,383.55 | $43,872.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $16,620.38 / $23,740.31
| Facility | | $1,787.00 | $16,620.38 | $23,740.31 |