- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,100.62 / $11,033.80 / $12,721.30
| Facility | | $9,100.62 | $11,033.80 | $12,721.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,615.24 / $21,615.24 / $21,615.24
| Facility | | $21,615.24 | $21,615.24 | $21,615.24 |
- 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
- $8,095.64 / $12,886.03 / $22,116.45
| Facility | | $8,095.64 | $12,886.03 | $22,116.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $19,154.56
| Facility | | $2,332.00 | $5,310.00 | $19,154.56 |