- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,173.30 / $26,022.40 / $34,920.00
| Facility | | $14,173.30 | $26,022.40 | $34,920.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,800.00 / $14,453.91 / $19,085.90
| Facility | | $1,800.00 | $14,453.91 | $19,085.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,185.00 / $21,008.67 / $35,015.87
| Facility | | $2,185.00 | $21,008.67 | $35,015.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,952.85 / $15,952.85 / $21,815.22
| Facility | | $15,952.85 | $15,952.85 | $21,815.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,293.56 / $20,639.12 / $29,237.82
| Facility | | $15,293.56 | $20,639.12 | $29,237.82 |