- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,620.48 / $10,515.10 / $17,598.50
| Facility | | $7,620.48 | $10,515.10 | $17,598.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,412.41 / $19,412.41 / $19,412.41
| Facility | | $19,412.41 | $19,412.41 | $19,412.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $12,225.06 / $18,659.04
| Facility | | $2,423.00 | $12,225.06 | $18,659.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,799.50 / $11,829.89 / $19,838.65
| Facility | | $7,799.50 | $11,829.89 | $19,838.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $9,547.37 / $21,229.69
| Facility | | $2,600.00 | $9,547.37 | $21,229.69 |