- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,015.50 / $13,355.50 / $15,398.10
| Facility | | $11,015.50 | $13,355.50 | $15,398.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,841.18 / $16,841.18 / $26,387.38
| Facility | | $16,841.18 | $16,841.18 | $26,387.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,067.00 / $4,334.00
| Facility | | $1,252.00 | $3,067.00 | $4,334.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,799.10 / $15,597.46 / $26,770.13
| Facility | | $9,799.10 | $15,597.46 | $26,770.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,137.00 / $15,178.47 / $23,570.21
| Facility | | $3,137.00 | $15,178.47 | $23,570.21 |