- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,421.00 / $11,558.00 / $19,892.80
| Facility | | $2,421.00 | $11,558.00 | $19,892.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,707.49 / $18,254.59 / $19,001.04
| Facility | | $13,707.49 | $18,254.59 | $19,001.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,176.99 / $14,186.05 / $23,614.81
| Facility | | $5,176.99 | $14,186.05 | $23,614.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,379.85 / $17,331.57 / $30,914.64
| Facility | | $12,379.85 | $17,331.57 | $30,914.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,936.00 / $14,933.00 / $23,503.00
| Facility | | $9,936.00 | $14,933.00 | $23,503.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,814.00 / $13,703.00 / $22,258.92
| Facility | | $9,814.00 | $13,703.00 | $22,258.92 |