- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,183.60 / $12,346.80 / $14,235.20
| Facility | | $10,183.60 | $12,346.80 | $14,235.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,387.51 / $10,387.51 / $10,387.51
| Facility | | $10,387.51 | $10,387.51 | $10,387.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,067.00 / $4,334.00
| Facility | | $1,252.00 | $3,067.00 | $4,334.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,059.02 / $14,419.46 / $24,748.31
| Facility | | $9,059.02 | $14,419.46 | $24,748.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $21,433.95
| Facility | | $2,332.00 | $5,310.00 | $21,433.95 |