- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,758.20 / $14,255.90 / $16,436.20
| Facility | | $11,758.20 | $14,255.90 | $16,436.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,119.10 / $17,876.87 / $26,604.19
| Facility | | $10,119.10 | $17,876.87 | $26,604.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,485.00 / $5,462.00
| Facility | | $1,252.00 | $3,485.00 | $5,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,459.71 / $16,648.99 / $28,574.87
| Facility | | $10,459.71 | $16,648.99 | $28,574.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,137.00 / $16,618.33 / $25,159.23
| Facility | | $3,137.00 | $16,618.33 | $25,159.23 |