- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,914.60 / $16,645.09 / $33,827.30
| Facility | | $12,914.60 | $16,645.09 | $33,827.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,917.74 / $16,192.66 / $18,512.40
| Facility | | $12,917.74 | $16,192.66 | $18,512.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,218.46 / $16,899.23 / $23,338.49
| Facility | | $10,218.46 | $16,899.23 | $23,338.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,255.80 / $1,255.80 / $1,255.80
| Facility | | $1,255.80 | $1,255.80 | $1,255.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $372.00 / $2,000.00 / $20,761.34
| Facility | | $372.00 | $2,000.00 | $20,761.34 |