- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,854.50 / $13,160.20 / $15,173.00
| Facility | | $10,854.50 | $13,160.20 | $15,173.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,155.88 / $14,155.88 / $14,155.88
| Facility | | $14,155.88 | $14,155.88 | $14,155.88 |
- 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
- $9,655.84 / $15,369.43 / $26,378.76
| Facility | | $9,655.84 | $15,369.43 | $26,378.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $22,846.05
| Facility | | $2,332.00 | $5,310.00 | $22,846.05 |