- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,665.10 / $15,355.50 / $17,703.90
| Facility | | $12,665.10 | $15,355.50 | $17,703.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,439.78 / $18,398.96 / $25,451.71
| Facility | | $12,439.78 | $18,398.96 | $25,451.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,067.00 / $4,334.00
| Facility | | $1,252.00 | $3,067.00 | $4,334.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,266.50 / $17,933.16 / $30,778.91
| Facility | | $11,266.50 | $17,933.16 | $30,778.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $26,656.93
| Facility | | $2,332.00 | $5,310.00 | $26,656.93 |