- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,972.50 / $13,303.30 / $15,338.00
| Facility | | $10,972.50 | $13,303.30 | $15,338.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,582.78 / $10,582.78 / $23,022.73
| Facility | | $10,582.78 | $10,582.78 | $23,022.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,485.00 / $5,462.00
| Facility | | $1,252.00 | $3,485.00 | $5,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,760.82 / $15,536.53 / $26,665.55
| Facility | | $9,760.82 | $15,536.53 | $26,665.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,137.00 / $15,227.12 / $23,478.14
| Facility | | $3,137.00 | $15,227.12 | $23,478.14 |