- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,182.00 / $21,738.80 / $35,014.90
| Facility | | $3,182.00 | $21,738.80 | $35,014.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,639.24 / $26,639.24 / $26,639.24
| Facility | | $26,639.24 | $26,639.24 | $26,639.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $17,962.74 / $43,387.13
| Facility | | $1,474.01 | $17,962.74 | $43,387.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,736.10 / $22,729.31 / $32,198.81
| Facility | | $15,736.10 | $22,729.31 | $32,198.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,755.08 / $23,258.91 / $56,126.17
| Facility | | $13,755.08 | $23,258.91 | $56,126.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,755.08 / $24,478.97 / $41,238.11
| Facility | | $13,755.08 | $24,478.97 | $41,238.11 |