- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,076.00 / $18,103.59 / $23,576.20
| Facility | | $4,076.00 | $18,103.59 | $23,576.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,092.00 / $18,730.22 / $25,882.53
| Facility | | $3,092.00 | $18,730.22 | $25,882.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,844.00 / $17,118.79 / $25,477.37
| Facility | | $5,844.00 | $17,118.79 | $25,477.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,047.00 / $18,304.00 / $23,326.00
| Facility | | $13,047.00 | $18,304.00 | $23,326.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $24,258.03 / $32,045.42
| Facility | | $5,274.00 | $24,258.03 | $32,045.42 |