- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,844.90 / $18,308.00 / $32,216.70
| Facility | | $10,844.90 | $18,308.00 | $32,216.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,588.91 / $11,201.98 / $18,575.66
| Facility | | $7,588.91 | $11,201.98 | $18,575.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,865.12 / $16,875.46 / $23,301.98
| Facility | | $9,865.12 | $16,875.46 | $23,301.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,210.35 / $38,210.35 / $44,843.09
| Facility | | $38,210.35 | $38,210.35 | $44,843.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $15,955.22 / $22,790.21
| Facility | | $1,787.00 | $15,955.22 | $22,790.21 |