- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,707.40 / $19,909.50 / $32,056.80
| Facility | | $8,707.40 | $19,909.50 | $32,056.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $9,926.08 / $26,386.44
| Facility | | $1,474.01 | $9,926.08 | $26,386.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,468.00 / $19,717.47 / $29,489.30
| Facility | | $13,468.00 | $19,717.47 | $29,489.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,827.83 / $17,459.50 / $36,667.11
| Facility | | $11,827.83 | $17,459.50 | $36,667.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,827.83 / $17,459.50 / $31,477.43
| Facility | | $11,827.83 | $17,459.50 | $31,477.43 |