- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,816.70 / $22,813.80 / $26,303.00
| Facility | | $18,816.70 | $22,813.80 | $26,303.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,868.09 / $24,313.60 / $42,601.58
| Facility | | $23,868.09 | $24,313.60 | $42,601.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,067.00 / $4,334.00
| Facility | | $1,252.00 | $3,067.00 | $4,334.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,738.80 / $26,643.55 / $45,728.67
| Facility | | $16,738.80 | $26,643.55 | $45,728.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $39,604.58
| Facility | | $2,332.00 | $5,310.00 | $39,604.58 |