- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,944.30 / $16,906.40 / $19,492.09
| Facility | | $13,944.30 | $16,906.40 | $19,492.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,552.82 / $10,552.82 / $17,614.58
| Facility | | $10,552.82 | $10,552.82 | $17,614.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $2,554.00 / $3,843.00
| Facility | | $1,252.00 | $2,554.00 | $3,843.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,404.46 / $19,744.48 / $33,887.69
| Facility | | $12,404.46 | $19,744.48 | $33,887.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $29,349.38
| Facility | | $2,332.00 | $5,310.00 | $29,349.38 |