- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,034.05 / $8,370.16 / $11,227.80
| Facility | | $4,034.05 | $8,370.16 | $11,227.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,258.90 / $19,258.90 / $19,258.90
| Facility | | $19,258.90 | $19,258.90 | $19,258.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $8,536.37 / $10,150.14
| Facility | | $2,651.00 | $8,536.37 | $10,150.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,114.64 / $8,643.10 / $13,603.98
| Facility | | $7,114.64 | $8,643.10 | $13,603.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $10,678.32
| Facility | | $1,350.00 | $5,713.00 | $10,678.32 |