- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,695.60 / $19,744.09 / $34,744.00
| Facility | | $11,695.60 | $19,744.09 | $34,744.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,194.00 / $12,198.23 / $19,998.65
| Facility | | $8,194.00 | $12,198.23 | $19,998.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,639.00 / $18,177.75 / $25,129.94
| Facility | | $10,639.00 | $18,177.75 | $25,129.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,939.10 / $38,939.10 / $45,698.34
| Facility | | $38,939.10 | $38,939.10 | $45,698.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $17,206.84 / $24,578.02
| Facility | | $1,787.00 | $17,206.84 | $24,578.02 |