- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,281.00 / $11,101.80 / $26,344.20
| Facility | | $4,281.00 | $11,101.80 | $26,344.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,365.00 / $13,768.63 / $24,103.55
| Facility | | $2,365.00 | $13,768.63 | $24,103.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,949.53 / $11,132.13 / $19,988.89
| Facility | | $2,949.53 | $11,132.13 | $19,988.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,759.74 / $17,244.18 / $26,522.10
| Facility | | $11,759.74 | $17,244.18 | $26,522.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,300.00 / $9,753.00 / $24,608.22
| Facility | | $3,300.00 | $9,753.00 | $24,608.22 |