- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,880.92 / $13,634.10 / $22,818.70
| Facility | | $9,880.92 | $13,634.10 | $22,818.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,618.50 / $17,694.50 / $22,401.04
| Facility | | $14,618.50 | $17,694.50 | $22,401.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $15,973.36 / $24,898.97
| Facility | | $2,423.00 | $15,973.36 | $24,898.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,113.04 / $15,338.95 / $25,723.33
| Facility | | $10,113.04 | $15,338.95 | $25,723.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $12,379.38 / $27,526.99
| Facility | | $2,600.00 | $12,379.38 | $27,526.99 |