- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,182.00 / $25,456.70 / $42,279.40
| Facility | | $3,182.00 | $25,456.70 | $42,279.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $17,464.41 / $39,890.44
| Facility | | $1,474.01 | $17,464.41 | $39,890.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,000.84 / $25,995.76 / $38,879.06
| Facility | | $19,000.84 | $25,995.76 | $38,879.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,593.96 / $23,018.83 / $48,342.38
| Facility | | $15,593.96 | $23,018.83 | $48,342.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,593.96 / $23,018.83 / $44,032.00
| Facility | | $15,593.96 | $23,018.83 | $44,032.00 |