- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,086.29 / $16,778.00 / $22,506.30
| Facility | | $8,086.29 | $16,778.00 | $22,506.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,467.61 / $22,369.52 / $24,771.77
| Facility | | $17,467.61 | $22,369.52 | $24,771.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $15,506.62 / $18,438.09
| Facility | | $2,651.00 | $15,506.62 | $18,438.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,261.33 / $17,325.15 / $27,269.26
| Facility | | $14,261.33 | $17,325.15 | $27,269.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $21,404.77
| Facility | | $1,350.00 | $5,713.00 | $21,404.77 |