- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,501.50 / $25,143.40 / $34,783.00
| Facility | | $7,501.50 | $25,143.40 | $34,783.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $14,747.73
| Facility | | $1,146.00 | $3,000.00 | $14,747.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,463.64 / $13,075.86 / $24,253.85
| Facility | | $9,463.64 | $13,075.86 | $24,253.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,463.64 / $13,502.70 / $24,253.85
| Facility | | $9,463.64 | $13,502.70 | $24,253.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $16,735.84 / $25,949.19
| Facility | | $5,419.00 | $16,735.84 | $25,949.19 |