- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,335.61 / $15,220.50 / $20,417.00
| Facility | | $7,335.61 | $15,220.50 | $20,417.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,334.88 / $16,461.41 / $25,557.37
| Facility | | $12,334.88 | $16,461.41 | $25,557.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $14,016.92 / $16,666.77
| Facility | | $2,651.00 | $14,016.92 | $16,666.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,937.41 / $15,716.80 / $24,737.76
| Facility | | $12,937.41 | $15,716.80 | $24,737.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $19,417.68
| Facility | | $1,350.00 | $5,713.00 | $19,417.68 |