- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,456.50 / $19,952.20 / $23,003.70
| Facility | | $16,456.50 | $19,952.20 | $23,003.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,247.08 / $21,247.08 / $21,247.08
| Facility | | $21,247.08 | $21,247.08 | $21,247.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,702.00 / $6,578.00
| Facility | | $1,252.00 | $3,702.00 | $6,578.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,639.20 / $23,301.57 / $39,992.78
| Facility | | $14,639.20 | $23,301.57 | $39,992.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,137.00 / $23,014.44 / $35,212.32
| Facility | | $3,137.00 | $23,014.44 | $35,212.32 |