- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $16,063.50 / $24,277.30
| Facility | | $4,804.00 | $16,063.50 | $24,277.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $577.00 / $1,187.00 / $2,495.00
| Facility | | $577.00 | $1,187.00 | $2,495.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,638.10 / $22,776.97 / $32,192.32
| Facility | | $9,638.10 | $22,776.97 | $32,192.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,598.60 / $36,990.33 / $36,990.33
| Facility | | $22,598.60 | $36,990.33 | $36,990.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,715.16 / $12,160.87 / $32,192.32
| Facility | | $8,715.16 | $12,160.87 | $32,192.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,176.51 / $11,994.08 / $27,310.09
| Facility | | $4,176.51 | $11,994.08 | $27,310.09 |