- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,474.00 / $14,305.50 / $25,173.60
| Facility | | $8,474.00 | $14,305.50 | $25,173.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,289.06 / $10,671.50 / $17,951.48
| Facility | | $7,289.06 | $10,671.50 | $17,951.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,708.43 / $13,186.19 / $18,348.33
| Facility | | $7,708.43 | $13,186.19 | $18,348.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,926.65 / $26,926.65 / $31,600.71
| Facility | | $26,926.65 | $26,926.65 | $31,600.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $12,467.13 / $17,807.87
| Facility | | $1,787.00 | $12,467.13 | $17,807.87 |