- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,754.70 / $13,039.30 / $15,033.50
| Facility | | $10,754.70 | $13,039.30 | $15,033.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,475.02 / $24,475.02 / $24,475.02
| Facility | | $24,475.02 | $24,475.02 | $24,475.02 |
- 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
- $9,567.10 / $15,228.18 / $26,136.33
| Facility | | $9,567.10 | $15,228.18 | $26,136.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,156.00 / $6,654.00 / $19,191.93
| Facility | | $2,156.00 | $6,654.00 | $19,191.93 |