- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,136.80 / $18,126.59 / $30,337.60
| Facility | | $13,136.80 | $18,126.59 | $30,337.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,774.07 / $29,774.07 / $29,774.07
| Facility | | $29,774.07 | $29,774.07 | $29,774.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $21,357.89 / $32,701.53
| Facility | | $2,423.00 | $21,357.89 | $32,701.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,445.37 / $20,393.25 / $34,199.37
| Facility | | $13,445.37 | $20,393.25 | $34,199.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $16,458.48 / $36,597.35
| Facility | | $2,600.00 | $16,458.48 | $36,597.35 |