- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,489.30 / $15,853.40 / $26,533.00
| Facility | | $11,489.30 | $15,853.40 | $26,533.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,971.82 / $15,971.82 / $15,971.82
| Facility | | $15,971.82 | $15,971.82 | $15,971.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,272.00 / $17,271.23 / $26,515.87
| Facility | | $3,272.00 | $17,271.23 | $26,515.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,759.22 / $17,835.79 / $29,910.50
| Facility | | $11,759.22 | $17,835.79 | $29,910.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,062.00 / $18,187.75 / $32,111.71
| Facility | | $4,062.00 | $18,187.75 | $32,111.71 |