- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,367.28 / $11,357.10 / $13,094.10
| Facility | | $9,367.28 | $11,357.10 | $13,094.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,639.90 / $15,862.77 / $22,975.49
| Facility | | $11,639.90 | $15,862.77 | $22,975.49 |
- 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
- $8,332.86 / $13,263.61 / $22,764.51
| Facility | | $8,332.86 | $13,263.61 | $22,764.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,156.00 / $5,310.00 / $20,096.56
| Facility | | $2,156.00 | $5,310.00 | $20,096.56 |