- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,489.30 / $15,853.40 / $26,533.00
| Facility | | $11,489.30 | $15,853.40 | $26,533.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,229.37 / $20,229.37 / $23,531.39
| Facility | | $20,229.37 | $20,229.37 | $23,531.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $18,128.59 / $27,920.98
| Facility | | $2,423.00 | $18,128.59 | $27,920.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,759.22 / $17,835.79 / $29,910.50
| Facility | | $11,759.22 | $17,835.79 | $29,910.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $14,394.46 / $32,007.76
| Facility | | $2,600.00 | $14,394.46 | $32,007.76 |