- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,120.20 / $14,332.40 / $29,127.30
| Facility | | $11,120.20 | $14,332.40 | $29,127.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,936.94 / $15,936.94 / $15,936.94
| Facility | | $15,936.94 | $15,936.94 | $15,936.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,510.84 / $13,175.56 / $15,063.07
| Facility | | $10,510.84 | $13,175.56 | $15,063.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,876.29 / $15,711.98 / $20,434.09
| Facility | | $8,876.29 | $15,711.98 | $20,434.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,081.00 / $13,081.00 / $18,867.99
| Facility | | $13,081.00 | $13,081.00 | $18,867.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,000.00 / $16,301.66 / $22,099.18
| Facility | | $2,000.00 | $16,301.66 | $22,099.18 |