- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,638.00 / $19,350.20 / $31,156.30
| Facility | | $1,638.00 | $19,350.20 | $31,156.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $2,555.21 / $14,700.42
| Facility | | $1,474.01 | $2,555.21 | $14,700.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,373.64 / $18,373.64 / $18,502.34
| Facility | | $18,373.64 | $18,373.64 | $18,502.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,243.73 / $16,969.07 / $35,637.14
| Facility | | $12,243.73 | $16,969.07 | $35,637.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,495.59 / $16,969.07 / $36,097.28
| Facility | | $11,495.59 | $16,969.07 | $36,097.28 |