- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,447.31 / $10,241.70 / $11,808.10
| Facility | | $8,447.31 | $10,241.70 | $11,808.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,138.88 / $17,138.88 / $17,138.88
| Facility | | $17,138.88 | $17,138.88 | $17,138.88 |
- 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
- $7,514.48 / $11,960.98 / $20,528.78
| Facility | | $7,514.48 | $11,960.98 | $20,528.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $17,779.52
| Facility | | $2,332.00 | $5,310.00 | $17,779.52 |