- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,078.00 / $15,212.00 / $34,704.69
| Facility | | $1,078.00 | $15,212.00 | $34,704.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,444.28 / $25,882.78 / $37,504.01
| Facility | | $21,444.28 | $25,882.78 | $37,504.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.36 / $20,738.16 / $32,338.71
| Facility | | $2,089.36 | $20,738.16 | $32,338.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,104.63 / $26,556.07 / $35,619.65
| Facility | | $17,104.63 | $26,556.07 | $35,619.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,298.18 / $28,636.41 / $44,171.97
| Facility | | $18,298.18 | $28,636.41 | $44,171.97 |