- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,056.76 / $9,768.20 / $11,262.20
| Facility | | $8,056.76 | $9,768.20 | $11,262.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,231.73 / $21,231.73 / $21,231.73
| Facility | | $21,231.73 | $21,231.73 | $21,231.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,715.00 / $8,731.00
| Facility | | $1,252.00 | $3,715.00 | $8,731.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,167.06 / $11,407.98 / $19,579.66
| Facility | | $7,167.06 | $11,407.98 | $19,579.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,137.00 / $11,205.58 / $17,239.25
| Facility | | $3,137.00 | $11,205.58 | $17,239.25 |