- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,480.60 / $15,131.80 / $17,446.00
| Facility | | $12,480.60 | $15,131.80 | $17,446.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,876.73 / $16,876.73 / $16,876.73
| Facility | | $16,876.73 | $16,876.73 | $16,876.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,485.00 / $5,462.00
| Facility | | $1,252.00 | $3,485.00 | $5,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,102.36 / $17,671.89 / $30,330.50
| Facility | | $11,102.36 | $17,671.89 | $30,330.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,137.00 / $17,197.16 / $26,705.00
| Facility | | $3,137.00 | $17,197.16 | $26,705.00 |