- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,833.20 / $18,288.20 / $32,181.90
| Facility | | $10,833.20 | $18,288.20 | $32,181.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,628.00 / $9,151.87 / $9,151.87
| Facility | | $2,628.00 | $9,151.87 | $9,151.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,902.39 / $12,755.35 / $20,912.04
| Facility | | $8,902.39 | $12,755.35 | $20,912.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,854.46 / $16,857.25 / $23,276.84
| Facility | | $9,854.46 | $16,857.25 | $23,276.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,293.65 / $34,293.65 / $40,246.51
| Facility | | $34,293.65 | $34,293.65 | $40,246.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $15,938.01 / $22,765.62
| Facility | | $1,787.00 | $15,938.01 | $22,765.62 |