- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,431.83 / $15,420.10 / $20,684.80
| Facility | | $7,431.83 | $15,420.10 | $20,684.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,302.52 / $8,302.52 / $8,302.52
| Facility | | $8,302.52 | $8,302.52 | $8,302.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $15,708.43 / $18,678.05
| Facility | | $2,651.00 | $15,708.43 | $18,678.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,107.10 / $15,922.95 / $25,062.24
| Facility | | $13,107.10 | $15,922.95 | $25,062.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,888.00 / $20,051.18
| Facility | | $1,350.00 | $5,888.00 | $20,051.18 |