- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,069.89 / $18,451.80 / $29,709.80
| Facility | | $8,069.89 | $18,451.80 | $29,709.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $12,474.62 / $24,749.11
| Facility | | $1,474.01 | $12,474.62 | $24,749.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,356.75 / $19,292.57 / $27,330.24
| Facility | | $13,356.75 | $19,292.57 | $27,330.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,430.00 / $18,268.00 / $33,982.53
| Facility | | $11,430.00 | $18,268.00 | $33,982.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,430.00 / $16,181.21 / $29,172.81
| Facility | | $11,430.00 | $16,181.21 | $29,172.81 |