- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,298.17 / $11,273.30 / $12,997.50
| Facility | | $9,298.17 | $11,273.30 | $12,997.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,307.26 / $22,307.26 / $22,307.26
| Facility | | $22,307.26 | $22,307.26 | $22,307.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,715.00 / $14,552.00
| Facility | | $1,252.00 | $3,715.00 | $14,552.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,271.37 / $13,165.76 / $22,596.55
| Facility | | $8,271.37 | $13,165.76 | $22,596.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,137.00 / $12,812.08 / $19,895.52
| Facility | | $3,137.00 | $12,812.08 | $19,895.52 |