- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,430.12 / $21,562.00 / $34,717.60
| Facility | | $9,430.12 | $21,562.00 | $34,717.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $11,334.06 / $27,496.63
| Facility | | $1,474.01 | $11,334.06 | $27,496.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,379.00 / $21,354.04 / $31,936.94
| Facility | | $15,379.00 | $21,354.04 | $31,936.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,809.56 / $18,908.66 / $39,710.51
| Facility | | $12,809.56 | $18,908.66 | $39,710.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,809.56 / $20,523.00 / $34,090.08
| Facility | | $12,809.56 | $20,523.00 | $34,090.08 |