- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,645.20 / $12,906.50 / $14,880.40
| Facility | | $10,645.20 | $12,906.50 | $14,880.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,092.01 / $15,092.01 / $15,092.01
| Facility | | $15,092.01 | $15,092.01 | $15,092.01 |
- 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
- $9,469.66 / $15,073.09 / $25,870.13
| Facility | | $9,469.66 | $15,073.09 | $25,870.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $22,405.54
| Facility | | $2,332.00 | $5,310.00 | $22,405.54 |