- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,847.09 / $12,207.60 / $20,431.20
| Facility | | $8,847.09 | $12,207.60 | $20,431.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,326.27 / $18,326.27 / $18,326.27
| Facility | | $18,326.27 | $18,326.27 | $18,326.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $13,871.05 / $21,363.66
| Facility | | $2,423.00 | $13,871.05 | $21,363.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,054.93 / $13,734.05 / $23,031.92
| Facility | | $9,054.93 | $13,734.05 | $23,031.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $11,084.14 / $24,646.87
| Facility | | $2,600.00 | $11,084.14 | $24,646.87 |