- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,331.88 / $11,063.00 / $14,840.10
| Facility | | $5,331.88 | $11,063.00 | $14,840.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,427.06 / $28,427.06 / $28,427.06
| Facility | | $28,427.06 | $28,427.06 | $28,427.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $6,873.82 / $8,173.29
| Facility | | $2,651.00 | $6,873.82 | $8,173.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,403.54 / $11,423.75 / $17,980.63
| Facility | | $9,403.54 | $11,423.75 | $17,980.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $5,468.00 / $14,113.74
| Facility | | $1,000.00 | $5,468.00 | $14,113.74 |