- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,186.00 / $16,076.30 / $19,055.40
| Facility | | $9,186.00 | $16,076.30 | $19,055.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,042.39 / $23,042.39 / $27,458.41
| Facility | | $23,042.39 | $23,042.39 | $27,458.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,715.00 / $8,731.00
| Facility | | $1,252.00 | $3,715.00 | $8,731.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,876.75 / $20,148.84 / $34,581.71
| Facility | | $12,876.75 | $20,148.84 | $34,581.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,121.00 / $20,111.74 / $29,952.63
| Facility | | $5,121.00 | $20,111.74 | $29,952.63 |