- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,626.61 / $10,459.10 / $12,058.70
| Facility | | $8,626.61 | $10,459.10 | $12,058.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,570.68 / $20,570.68 / $20,570.68
| Facility | | $20,570.68 | $20,570.68 | $20,570.68 |
- 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
- $7,673.98 / $12,214.86 / $20,964.52
| Facility | | $7,673.98 | $12,214.86 | $20,964.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,156.00 / $5,310.00 / $18,507.52
| Facility | | $2,156.00 | $5,310.00 | $18,507.52 |