- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,269.32 / $10,025.90 / $11,559.30
| Facility | | $8,269.32 | $10,025.90 | $11,559.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,198.98 / $20,198.98 / $20,198.98
| Facility | | $20,198.98 | $20,198.98 | $20,198.98 |
- 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
- $7,356.14 / $11,708.95 / $20,096.21
| Facility | | $7,356.14 | $11,708.95 | $20,096.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $17,404.88
| Facility | | $2,332.00 | $5,310.00 | $17,404.88 |