- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,890.50 / $14,416.30 / $16,621.20
| Facility | | $11,890.50 | $14,416.30 | $16,621.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,876.29 / $13,876.29 / $13,876.29
| Facility | | $13,876.29 | $13,876.29 | $13,876.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,715.00 / $8,731.00
| Facility | | $1,252.00 | $3,715.00 | $8,731.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,577.46 / $16,836.40 / $28,896.53
| Facility | | $10,577.46 | $16,836.40 | $28,896.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,137.00 / $16,805.40 / $25,442.44
| Facility | | $3,137.00 | $16,805.40 | $25,442.44 |