- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,656.10 / $16,557.00 / $19,089.30
| Facility | | $13,656.10 | $16,557.00 | $19,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,405.73 / $24,270.97 / $31,290.48
| Facility | | $20,405.73 | $24,270.97 | $31,290.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,715.00 / $8,731.00
| Facility | | $1,252.00 | $3,715.00 | $8,731.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,148.10 / $19,122.79 / $33,187.35
| Facility | | $12,148.10 | $19,122.79 | $33,187.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,137.00 / $18,823.59 / $29,220.37
| Facility | | $3,137.00 | $18,823.59 | $29,220.37 |