- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,727.00 / $18,107.40 / $24,289.60
| Facility | | $8,727.00 | $18,107.40 | $24,289.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,317.57 / $19,512.14 / $33,104.03
| Facility | | $18,317.57 | $19,512.14 | $33,104.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $18,662.50 / $22,190.58
| Facility | | $2,651.00 | $18,662.50 | $22,190.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,391.32 / $18,697.90 / $29,429.92
| Facility | | $15,391.32 | $18,697.90 | $29,429.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $23,100.76
| Facility | | $1,350.00 | $5,713.00 | $23,100.76 |