- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,326.10 / $14,944.40 / $17,230.00
| Facility | | $12,326.10 | $14,944.40 | $17,230.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,538.20 / $22,538.20 / $22,538.20
| Facility | | $22,538.20 | $22,538.20 | $22,538.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,485.00 / $5,462.00
| Facility | | $1,252.00 | $3,485.00 | $5,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.90 / $17,453.09 / $29,954.97
| Facility | | $10,964.90 | $17,453.09 | $29,954.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,137.00 / $16,984.25 / $26,374.37
| Facility | | $3,137.00 | $16,984.25 | $26,374.37 |