- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,450.40 / $13,882.80 / $16,006.00
| Facility | | $11,450.40 | $13,882.80 | $16,006.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,475.05 / $15,475.05 / $23,456.12
| Facility | | $15,475.05 | $15,475.05 | $23,456.12 |
- 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
- $10,185.95 / $16,213.24 / $27,826.99
| Facility | | $10,185.95 | $16,213.24 | $27,826.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $24,100.33
| Facility | | $2,332.00 | $5,310.00 | $24,100.33 |