- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,628.74 / $11,674.10 / $13,459.60
| Facility | | $9,628.74 | $11,674.10 | $13,459.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,702.85 / $12,702.85 / $22,067.60
| Facility | | $12,702.85 | $12,702.85 | $22,067.60 |
- 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
- $8,565.44 / $13,633.82 / $23,399.90
| Facility | | $8,565.44 | $13,633.82 | $23,399.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $20,266.13
| Facility | | $2,332.00 | $5,310.00 | $20,266.13 |