- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,245.78 / $19,183.80 / $25,733.50
| Facility | | $9,245.78 | $19,183.80 | $25,733.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,761.40 / $27,761.40 / $27,761.40
| Facility | | $27,761.40 | $27,761.40 | $27,761.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $22,385.78 / $26,617.73
| Facility | | $2,651.00 | $22,385.78 | $26,617.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,306.26 / $19,809.40 / $31,179.39
| Facility | | $16,306.26 | $19,809.40 | $31,179.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $24,473.99
| Facility | | $1,350.00 | $5,713.00 | $24,473.99 |