- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,290.50 / $17,326.20 / $19,976.09
| Facility | | $14,290.50 | $17,326.20 | $19,976.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,898.20 / $19,898.20 / $19,898.20
| Facility | | $19,898.20 | $19,898.20 | $19,898.20 |
- 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
- $12,712.44 / $20,234.70 / $34,729.07
| Facility | | $12,712.44 | $20,234.70 | $34,729.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,137.00 / $20,197.43 / $30,577.80
| Facility | | $3,137.00 | $20,197.43 | $30,577.80 |