- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,182.00 / $17,974.40 / $28,951.50
| Facility | | $3,182.00 | $17,974.40 | $28,951.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $11,808.87 / $26,927.92
| Facility | | $1,474.01 | $11,808.87 | $26,927.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,011.12 / $19,551.05 / $26,623.02
| Facility | | $13,011.12 | $19,551.05 | $26,623.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,678.20 / $15,852.00 / $44,032.00
| Facility | | $10,678.20 | $15,852.00 | $44,032.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,678.20 / $15,852.00 / $34,097.01
| Facility | | $10,678.20 | $15,852.00 | $34,097.01 |