- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,188.79 / $12,353.10 / $14,242.40
| Facility | | $10,188.79 | $12,353.10 | $14,242.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,897.56 / $15,897.56 / $22,133.22
| Facility | | $15,897.56 | $15,897.56 | $22,133.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $2,554.00 / $3,843.00
| Facility | | $1,252.00 | $2,554.00 | $3,843.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,063.66 / $14,426.85 / $24,760.98
| Facility | | $9,063.66 | $14,426.85 | $24,760.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $21,444.93
| Facility | | $2,332.00 | $5,310.00 | $21,444.93 |