- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,201.80 / $16,836.59 / $28,178.50
| Facility | | $12,201.80 | $16,836.59 | $28,178.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,085.07 / $25,850.59 / $25,991.33
| Facility | | $21,085.07 | $25,850.59 | $25,991.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $19,574.07 / $30,147.25
| Facility | | $2,423.00 | $19,574.07 | $30,147.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,488.49 / $18,941.90 / $31,765.46
| Facility | | $12,488.49 | $18,941.90 | $31,765.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $15,287.16 / $33,992.78
| Facility | | $2,600.00 | $15,287.16 | $33,992.78 |