- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,352.00 / $15,658.20 / $17,294.40
| Facility | | $6,352.00 | $15,658.20 | $17,294.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,745.94 / $15,745.94 / $15,745.94
| Facility | | $15,745.94 | $15,745.94 | $15,745.94 |
- 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
- $11,686.72 / $18,286.75 / $31,385.78
| Facility | | $11,686.72 | $18,286.75 | $31,385.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,505.00 / $27,182.52
| Facility | | $2,332.00 | $5,505.00 | $27,182.52 |