- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,059.60 / $12,965.50 / $26,349.30
| Facility | | $10,059.60 | $12,965.50 | $26,349.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,199.49 / $14,199.49 / $14,199.49
| Facility | | $14,199.49 | $14,199.49 | $14,199.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,556.28 / $13,232.52 / $15,128.19
| Facility | | $10,556.28 | $13,232.52 | $15,128.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,029.74 / $14,213.48 / $18,485.24
| Facility | | $8,029.74 | $14,213.48 | $18,485.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,329.41 / $16,329.41 / $16,329.41
| Facility | | $16,329.41 | $16,329.41 | $16,329.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $11,398.86 / $17,554.52
| Facility | | $1,286.00 | $11,398.86 | $17,554.52 |