- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,710.00 / $20,518.20 / $22,662.20
| Facility | | $9,710.00 | $20,518.20 | $22,662.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,679.73 / $25,679.73 / $37,480.86
| Facility | | $25,679.73 | $25,679.73 | $37,480.86 |
- 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
- $15,314.04 / $24,928.14 / $41,127.28
| Facility | | $15,314.04 | $24,928.14 | $41,127.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,121.00 / $23,378.00 / $35,622.01
| Facility | | $5,121.00 | $23,378.00 | $35,622.01 |