- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,870.21 / $13,074.50 / $22,875.40
| Facility | | $9,870.21 | $13,074.50 | $22,875.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,613.20 / $20,613.20 / $20,613.20
| Facility | | $20,613.20 | $20,613.20 | $20,613.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,843.91 / $12,628.02 / $24,925.51
| Facility | | $5,843.91 | $12,628.02 | $24,925.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,366.02 / $13,307.00 / $20,423.70
| Facility | | $9,366.02 | $13,307.00 | $20,423.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $14,891.56 / $20,579.66
| Facility | | $3,496.00 | $14,891.56 | $20,579.66 |