- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,007.90 / $14,558.60 / $16,785.30
| Facility | | $12,007.90 | $14,558.60 | $16,785.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,381.46 / $16,381.46 / $16,381.46
| Facility | | $16,381.46 | $16,381.46 | $16,381.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,067.00 / $4,334.00
| Facility | | $1,252.00 | $3,067.00 | $4,334.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,681.86 / $17,002.57 / $29,181.74
| Facility | | $10,681.86 | $17,002.57 | $29,181.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $25,273.65
| Facility | | $2,332.00 | $5,310.00 | $25,273.65 |