- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,701.40 / $14,187.10 / $16,356.90
| Facility | | $11,701.40 | $14,187.10 | $16,356.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,835.64 / $18,835.64 / $18,835.64
| Facility | | $18,835.64 | $18,835.64 | $18,835.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,485.00 / $5,462.00
| Facility | | $1,252.00 | $3,485.00 | $5,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,409.26 / $16,568.66 / $28,437.02
| Facility | | $10,409.26 | $16,568.66 | $28,437.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $24,628.67
| Facility | | $2,332.00 | $5,310.00 | $24,628.67 |