- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.00 / $18,254.29 / $37,245.69
| Facility | | $1,584.00 | $18,254.29 | $37,245.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,668.58 / $14,668.58 / $23,049.88
| Facility | | $14,668.58 | $14,668.58 | $23,049.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,201.00 / $14,824.26 / $22,858.52
| Facility | | $6,201.00 | $14,824.26 | $22,858.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,853.92 / $18,560.16 / $32,519.89
| Facility | | $13,853.92 | $18,560.16 | $32,519.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,535.00 / $12,375.00 / $27,309.12
| Facility | | $3,535.00 | $12,375.00 | $27,309.12 |