- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,280.40 / $23,561.10 / $30,551.30
| Facility | | $15,280.40 | $23,561.10 | $30,551.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,501.14 / $23,385.00 / $31,743.38
| Facility | | $13,501.14 | $23,385.00 | $31,743.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,817.00 / $4,817.00 / $4,817.00
| Facility | | $4,817.00 | $4,817.00 | $4,817.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,897.00 / $15,752.00 / $24,210.00
| Facility | | $10,897.00 | $15,752.00 | $24,210.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,908.00 / $16,813.00 / $28,157.73
| Facility | | $4,908.00 | $16,813.00 | $28,157.73 |