- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,266.87 / $11,235.40 / $12,953.70
| Facility | | $9,266.87 | $11,235.40 | $12,953.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,707.47 / $13,707.47 / $13,707.47
| Facility | | $13,707.47 | $13,707.47 | $13,707.47 |
- 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
- $8,243.54 / $13,121.44 / $22,520.50
| Facility | | $8,243.54 | $13,121.44 | $22,520.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $19,504.50
| Facility | | $2,332.00 | $5,310.00 | $19,504.50 |