- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,801.20 / $14,308.00 / $16,496.30
| Facility | | $11,801.20 | $14,308.00 | $16,496.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,881.19 / $22,881.19 / $22,881.19
| Facility | | $22,881.19 | $22,881.19 | $22,881.19 |
- 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
- $10,498.00 / $16,709.91 / $28,679.45
| Facility | | $10,498.00 | $16,709.91 | $28,679.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $24,838.63
| Facility | | $2,332.00 | $5,310.00 | $24,838.63 |