- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,483.00 / $19,676.00 / $26,393.70
| Facility | | $9,483.00 | $19,676.00 | $26,393.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,741.59 / $19,741.59 / $19,741.59
| Facility | | $19,741.59 | $19,741.59 | $19,741.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $16,657.65 / $19,806.72
| Facility | | $2,651.00 | $16,657.65 | $19,806.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,724.63 / $20,317.65 / $31,979.36
| Facility | | $16,724.63 | $20,317.65 | $31,979.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $25,101.92
| Facility | | $1,350.00 | $5,713.00 | $25,101.92 |