- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,929.01 / $14,376.80 / $19,285.30
| Facility | | $6,929.01 | $14,376.80 | $19,285.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,065.87 / $21,065.87 / $21,065.87
| Facility | | $21,065.87 | $21,065.87 | $21,065.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $13,178.43 / $15,669.77
| Facility | | $2,651.00 | $13,178.43 | $15,669.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,220.31 / $14,845.65 / $23,366.60
| Facility | | $12,220.31 | $14,845.65 | $23,366.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $18,341.41
| Facility | | $1,350.00 | $5,713.00 | $18,341.41 |