- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,962.70 / $18,141.20 / $20,915.70
| Facility | | $14,962.70 | $18,141.20 | $20,915.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,820.22 / $21,820.22 / $21,820.22
| Facility | | $21,820.22 | $21,820.22 | $21,820.22 |
- 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
- $13,310.42 / $21,186.52 / $36,362.69
| Facility | | $13,310.42 | $21,186.52 | $36,362.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $31,492.91
| Facility | | $2,332.00 | $5,310.00 | $31,492.91 |