- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,182.00 / $18,785.00 / $30,246.20
| Facility | | $3,182.00 | $18,785.00 | $30,246.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $10,185.96 / $26,088.24
| Facility | | $1,474.01 | $10,185.96 | $26,088.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,074.66 / $18,603.79 / $27,823.69
| Facility | | $13,074.66 | $18,603.79 | $27,823.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,886.06 / $16,473.36 / $34,596.08
| Facility | | $11,886.06 | $16,473.36 | $34,596.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,159.78 / $16,473.36 / $35,042.79
| Facility | | $11,159.78 | $16,473.36 | $35,042.79 |