- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,850.08 / $9,517.62 / $10,973.30
| Facility | | $7,850.08 | $9,517.62 | $10,973.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,321.88 / $17,321.88 / $17,321.88
| Facility | | $17,321.88 | $17,321.88 | $17,321.88 |
- 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
- $6,983.20 / $11,115.33 / $19,077.38
| Facility | | $6,983.20 | $11,115.33 | $19,077.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $16,522.49
| Facility | | $2,332.00 | $5,310.00 | $16,522.49 |