- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,834.70 / $17,170.59 / $28,507.20
| Facility | | $10,834.70 | $17,170.59 | $28,507.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,988.00 / $2,988.00 / $22,755.94
| Facility | | $2,988.00 | $2,988.00 | $22,755.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,333.04 / $15,479.50 / $26,222.60
| Facility | | $10,333.04 | $15,479.50 | $26,222.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,902.07 / $19,131.41 / $29,715.00
| Facility | | $14,902.07 | $19,131.41 | $29,715.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,200.62 / $18,496.93 / $29,474.39
| Facility | | $9,200.62 | $18,496.93 | $29,474.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,200.62 / $18,496.93 / $26,208.00
| Facility | | $9,200.62 | $18,496.93 | $26,208.00 |