- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,494.80 / $15,149.50 / $22,128.00
| Facility | | $11,494.80 | $15,149.50 | $22,128.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,460.56 / $23,300.66 / $27,703.57
| Facility | | $14,460.56 | $23,300.66 | $27,703.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,715.00 / $14,552.00
| Facility | | $1,252.00 | $3,715.00 | $14,552.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,225.40 / $16,276.02 / $27,934.74
| Facility | | $10,225.40 | $16,276.02 | $27,934.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,137.00 / $16,246.05 / $24,595.61
| Facility | | $3,137.00 | $16,246.05 | $24,595.61 |