- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,810.00 / $20,942.59 / $36,641.60
| Facility | | $15,810.00 | $20,942.59 | $36,641.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,980.65 / $13,980.65 / $13,980.65
| Facility | | $13,980.65 | $13,980.65 | $13,980.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $18,029.18 / $36,606.71
| Facility | | $5,939.30 | $18,029.18 | $36,606.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,134.00 / $20,092.68 / $32,714.55
| Facility | | $13,134.00 | $20,092.68 | $32,714.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $21,582.35 / $32,964.37
| Facility | | $3,496.00 | $21,582.35 | $32,964.37 |