- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,090.67 / $9,809.31 / $11,309.60
| Facility | | $8,090.67 | $9,809.31 | $11,309.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,039.40 / $19,039.40 / $19,039.40
| Facility | | $19,039.40 | $19,039.40 | $19,039.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $2,554.00 / $3,843.00
| Facility | | $1,252.00 | $2,554.00 | $3,843.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,197.22 / $11,455.99 / $19,662.06
| Facility | | $7,197.22 | $11,455.99 | $19,662.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $17,028.87
| Facility | | $2,332.00 | $5,310.00 | $17,028.87 |