- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,765.30 / $18,701.20 / $29,446.40
| Facility | | $13,765.30 | $18,701.20 | $29,446.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,202.00 / $17,067.00 / $24,937.50
| Facility | | $11,202.00 | $17,067.00 | $24,937.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,008.40 / $16,578.32 / $30,006.00
| Facility | | $12,008.40 | $16,578.32 | $30,006.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.00 / $175.82 / $280.20
| Facility | | $125.00 | $175.82 | $280.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,226.64 / $18,305.16 / $30,126.02
| Facility | | $13,226.64 | $18,305.16 | $30,126.02 |