- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,019.29 / $12,147.60 / $14,005.50
| Facility | | $10,019.29 | $12,147.60 | $14,005.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,930.86 / $11,930.86 / $11,930.86
| Facility | | $11,930.86 | $11,930.86 | $11,930.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,715.00 / $14,552.00
| Facility | | $1,252.00 | $3,715.00 | $14,552.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.86 / $14,186.81 / $24,349.01
| Facility | | $8,912.86 | $14,186.81 | $24,349.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,137.00 / $14,157.62 / $26,454.29
| Facility | | $3,137.00 | $14,157.62 | $26,454.29 |