- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,310.90 / $7,328.20 / $12,264.80
| Facility | | $5,310.90 | $7,328.20 | $12,264.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,192.04 / $18,192.04 / $18,192.04
| Facility | | $18,192.04 | $18,192.04 | $18,192.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $8,628.79 / $13,046.29
| Facility | | $2,423.00 | $8,628.79 | $13,046.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,435.66 / $8,244.54 / $13,826.04
| Facility | | $5,435.66 | $8,244.54 | $13,826.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $6,653.80 / $14,795.49
| Facility | | $2,600.00 | $6,653.80 | $14,795.49 |