- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,490.00 / $12,718.40 / $14,663.50
| Facility | | $10,490.00 | $12,718.40 | $14,663.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,453.68 / $19,453.68 / $23,834.40
| Facility | | $19,453.68 | $19,453.68 | $23,834.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $800.00 / $850.00 / $1,246.00
| Facility | | $800.00 | $850.00 | $1,246.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,125.68 / $10,136.07 / $25,493.02
| Facility | | $9,125.68 | $10,136.07 | $25,493.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $22,078.93
| Facility | | $2,332.00 | $5,310.00 | $22,078.93 |