- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,316.00 / $11,180.50 / $21,237.60
| Facility | | $4,316.00 | $11,180.50 | $21,237.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $13,469.98 / $25,799.15
| Facility | | $3,308.00 | $13,469.98 | $25,799.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.56 / $10,290.85 / $15,197.83
| Facility | | $2,884.56 | $10,290.85 | $15,197.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,136.26 / $17,307.00 / $25,637.48
| Facility | | $11,136.26 | $17,307.00 | $25,637.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,300.00 / $9,753.00 / $23,289.14
| Facility | | $3,300.00 | $9,753.00 | $23,289.14 |