- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,088.80 / $24,706.40 / $30,361.90
| Facility | | $13,088.80 | $24,706.40 | $30,361.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,152.00 / $22,135.77 / $34,755.35
| Facility | | $2,152.00 | $22,135.77 | $34,755.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,866.00 / $22,045.87 / $34,151.28
| Facility | | $15,866.00 | $22,045.87 | $34,151.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,587.00 / $24,721.00 / $32,954.00
| Facility | | $14,587.00 | $24,721.00 | $32,954.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,297.00 / $2,235.00 / $39,726.24
| Facility | | $1,297.00 | $2,235.00 | $39,726.24 |