- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,241.66 / $11,372.20 / $19,033.00
| Facility | | $8,241.66 | $11,372.20 | $19,033.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,386.35 / $21,386.35 / $21,386.35
| Facility | | $21,386.35 | $21,386.35 | $21,386.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $12,293.06 / $19,408.41
| Facility | | $2,423.00 | $12,293.06 | $19,408.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,435.27 / $12,794.20 / $21,455.79
| Facility | | $8,435.27 | $12,794.20 | $21,455.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $10,325.62 / $22,960.22
| Facility | | $2,600.00 | $10,325.62 | $22,960.22 |