- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,918.60 / $14,450.30 / $16,660.40
| Facility | | $11,918.60 | $14,450.30 | $16,660.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,532.51 / $14,532.51 / $14,532.51
| Facility | | $14,532.51 | $14,532.51 | $14,532.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,702.00 / $6,578.00
| Facility | | $1,252.00 | $3,702.00 | $6,578.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,602.40 / $16,876.09 / $28,964.66
| Facility | | $10,602.40 | $16,876.09 | $28,964.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,156.00 / $5,310.00 / $25,570.06
| Facility | | $2,156.00 | $5,310.00 | $25,570.06 |