- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,922.00 / $11,213.49 / $24,291.30
| Facility | | $2,922.00 | $11,213.49 | $24,291.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,970.18 / $14,970.18 / $14,970.18
| Facility | | $14,970.18 | $14,970.18 | $14,970.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,356.00 / $10,632.80 / $20,012.57
| Facility | | $5,356.00 | $10,632.80 | $20,012.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,092.48 / $15,848.50 / $21,795.66
| Facility | | $9,092.48 | $15,848.50 | $21,795.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,457.00 / $17,173.62 / $25,318.37
| Facility | | $10,457.00 | $17,173.62 | $25,318.37 |