- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,627.90 / $15,310.40 / $17,652.00
| Facility | | $12,627.90 | $15,310.40 | $17,652.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,781.21 / $24,435.79 / $32,725.04
| Facility | | $19,781.21 | $24,435.79 | $32,725.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,702.00 / $6,578.00
| Facility | | $1,252.00 | $3,702.00 | $6,578.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,233.44 / $17,880.54 / $30,688.60
| Facility | | $11,233.44 | $17,880.54 | $30,688.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $26,578.71
| Facility | | $2,332.00 | $5,310.00 | $26,578.71 |