- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,801.83 / $9,459.12 / $10,905.80
| Facility | | $7,801.83 | $9,459.12 | $10,905.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,502.98 / $17,502.98 / $17,502.98
| Facility | | $17,502.98 | $17,502.98 | $17,502.98 |
- 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
- $6,940.28 / $11,047.01 / $18,960.13
| Facility | | $6,940.28 | $11,047.01 | $18,960.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $16,420.93
| Facility | | $2,332.00 | $5,310.00 | $16,420.93 |