- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $13,958.50 / $21,076.30
| Facility | | $4,804.00 | $13,958.50 | $21,076.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,025.10 / $15,303.73
| Facility | | $688.00 | $3,025.10 | $15,303.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,951.00 / $12,405.92 / $24,506.89
| Facility | | $6,951.00 | $12,405.92 | $24,506.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,601.00 / $30,446.90 / $30,446.90
| Facility | | $18,601.00 | $30,446.90 | $30,446.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,178.00 / $11,621.25 / $26,804.18
| Facility | | $8,178.00 | $11,621.25 | $26,804.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,859.54 / $12,404.06 / $24,280.97
| Facility | | $4,859.54 | $12,404.06 | $24,280.97 |