- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,990.29 / $11,025.30 / $18,452.50
| Facility | | $7,990.29 | $11,025.30 | $18,452.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,303.72 / $17,303.72 / $17,303.72
| Facility | | $17,303.72 | $17,303.72 | $17,303.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $12,905.54 / $19,512.49
| Facility | | $2,423.00 | $12,905.54 | $19,512.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,178.00 / $12,403.97 / $20,801.39
| Facility | | $8,178.00 | $12,403.97 | $20,801.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $10,010.69 / $22,259.93
| Facility | | $2,600.00 | $10,010.69 | $22,259.93 |