- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,761.40 / $14,259.80 / $16,440.70
| Facility | | $11,761.40 | $14,259.80 | $16,440.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,658.66 / $19,658.66 / $19,658.66
| Facility | | $19,658.66 | $19,658.66 | $19,658.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,702.00 / $6,578.00
| Facility | | $1,252.00 | $3,702.00 | $6,578.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,462.62 / $16,653.59 / $28,582.80
| Facility | | $10,462.62 | $16,653.59 | $28,582.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,137.00 / $16,622.93 / $25,166.21
| Facility | | $3,137.00 | $16,622.93 | $25,166.21 |