- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,974.00 / $18,401.80 / $24,684.50
| Facility | | $6,974.00 | $18,401.80 | $24,684.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,250.01 / $27,250.01 / $36,576.10
| Facility | | $27,250.01 | $27,250.01 | $36,576.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,897.00 / $21,119.93 / $25,112.57
| Facility | | $3,897.00 | $21,119.93 | $25,112.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,641.56 / $19,001.90 / $29,908.41
| Facility | | $15,641.56 | $19,001.90 | $29,908.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $23,476.35 / $29,648.96
| Facility | | $1,350.00 | $23,476.35 | $29,648.96 |