- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,199.01 / $9,933.49 / $16,625.09
| Facility | | $7,199.01 | $9,933.49 | $16,625.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,830.71 / $14,830.71 / $14,830.71
| Facility | | $14,830.71 | $14,830.71 | $14,830.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $11,071.79 / $17,152.30
| Facility | | $2,423.00 | $11,071.79 | $17,152.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,368.13 / $11,175.61 / $18,741.41
| Facility | | $7,368.13 | $11,175.61 | $18,741.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $9,019.33 / $20,055.53
| Facility | | $2,600.00 | $9,019.33 | $20,055.53 |