- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,638.58 / $13,774.20 / $18,476.90
| Facility | | $6,638.58 | $13,774.20 | $18,476.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,861.30 / $15,861.30 / $15,861.30
| Facility | | $15,861.30 | $15,861.30 | $15,861.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,897.00 / $13,744.58 / $16,342.94
| Facility | | $3,897.00 | $13,744.58 | $16,342.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,708.10 / $14,223.40 / $22,387.20
| Facility | | $11,708.10 | $14,223.40 | $22,387.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $17,572.64 / $22,193.00
| Facility | | $1,350.00 | $17,572.64 | $22,193.00 |