- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,410.82 / $15,887.00 / $27,956.60
| Facility | | $9,410.82 | $15,887.00 | $27,956.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,628.00 / $2,628.00 / $8,375.14
| Facility | | $2,628.00 | $2,628.00 | $8,375.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,498.61 / $27,082.75 / $44,779.82
| Facility | | $18,498.61 | $27,082.75 | $44,779.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,560.61 / $14,643.95 / $20,220.66
| Facility | | $8,560.61 | $14,643.95 | $20,220.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,175.55 / $30,175.55 / $35,413.57
| Facility | | $30,175.55 | $30,175.55 | $35,413.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $13,845.40 / $19,776.57
| Facility | | $1,787.00 | $13,845.40 | $19,776.57 |