- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,529.45 / $10,341.29 / $11,922.90
| Facility | | $8,529.45 | $10,341.29 | $11,922.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,230.86 / $20,230.86 / $20,230.86
| Facility | | $20,230.86 | $20,230.86 | $20,230.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,485.00 / $5,462.00
| Facility | | $1,252.00 | $3,485.00 | $5,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,587.56 / $12,077.30 / $20,728.43
| Facility | | $7,587.56 | $12,077.30 | $20,728.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $17,952.43
| Facility | | $2,332.00 | $5,310.00 | $17,952.43 |