- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,409.01 / $11,407.70 / $13,152.40
| Facility | | $9,409.01 | $11,407.70 | $13,152.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,612.16 / $14,612.16 / $14,612.16
| Facility | | $14,612.16 | $14,612.16 | $14,612.16 |
- 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
- $8,369.98 / $13,322.70 / $22,865.92
| Facility | | $8,369.98 | $13,322.70 | $22,865.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,137.00 / $12,964.81 / $20,132.68
| Facility | | $3,137.00 | $12,964.81 | $20,132.68 |