- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,306.60 / $15,601.30 / $26,111.10
| Facility | | $11,306.60 | $15,601.30 | $26,111.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,965.22 / $12,965.22 / $25,697.67
| Facility | | $12,965.22 | $12,965.22 | $25,697.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $18,298.45 / $28,706.10
| Facility | | $2,423.00 | $18,298.45 | $28,706.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,572.23 / $17,552.16 / $29,434.87
| Facility | | $11,572.23 | $17,552.16 | $29,434.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $14,165.57 / $31,498.78
| Facility | | $2,600.00 | $14,165.57 | $31,498.78 |