- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,162.30 / $18,383.09 / $21,194.60
| Facility | | $15,162.30 | $18,383.09 | $21,194.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,027.60 / $23,052.38 / $27,045.06
| Facility | | $21,027.60 | $23,052.38 | $27,045.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,485.00 / $5,462.00
| Facility | | $1,252.00 | $3,485.00 | $5,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,487.90 / $21,469.02 / $36,847.55
| Facility | | $13,487.90 | $21,469.02 | $36,847.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,137.00 / $21,424.83 / $40,033.48
| Facility | | $3,137.00 | $21,424.83 | $40,033.48 |