- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,728.70 / $18,111.80 / $31,871.60
| Facility | | $10,728.70 | $18,111.80 | $31,871.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,256.00 / $10,619.59 / $21,024.00
| Facility | | $5,256.00 | $10,619.59 | $21,024.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,252.02 / $13,773.28 / $22,646.51
| Facility | | $9,252.02 | $13,773.28 | $22,646.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,759.45 / $16,694.70 / $23,052.39
| Facility | | $9,759.45 | $16,694.70 | $23,052.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,440.48 / $48,537.00 / $48,537.00
| Facility | | $16,440.48 | $48,537.00 | $48,537.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,520.00 / $17,222.18 / $24,854.00
| Facility | | $2,520.00 | $17,222.18 | $24,854.00 |