- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,422.70 / $14,381.70 / $24,069.90
| Facility | | $10,422.70 | $14,381.70 | $24,069.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,545.98 / $23,545.98 / $23,545.98
| Facility | | $23,545.98 | $23,545.98 | $23,545.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $16,878.18 / $25,526.15
| Facility | | $2,423.00 | $16,878.18 | $25,526.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,667.57 / $16,180.03 / $27,133.81
| Facility | | $10,667.57 | $16,180.03 | $27,133.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $13,058.18 / $29,036.37
| Facility | | $2,600.00 | $13,058.18 | $29,036.37 |