- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,460.00 / $12,682.00 / $14,621.60
| Facility | | $10,460.00 | $12,682.00 | $14,621.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,133.96 / $20,133.96 / $20,133.96
| Facility | | $20,133.96 | $20,133.96 | $20,133.96 |
- 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
- $9,304.94 / $14,810.90 / $25,420.13
| Facility | | $9,304.94 | $14,810.90 | $25,420.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $22,015.81
| Facility | | $2,332.00 | $5,310.00 | $22,015.81 |