- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,270.01 / $11,411.30 / $19,098.50
| Facility | | $8,270.01 | $11,411.30 | $19,098.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,767.68 / $19,767.68 / $19,767.68
| Facility | | $19,767.68 | $19,767.68 | $19,767.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,272.00 / $12,521.36 / $19,371.75
| Facility | | $3,272.00 | $12,521.36 | $19,371.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,464.29 / $12,838.21 / $21,529.59
| Facility | | $8,464.29 | $12,838.21 | $21,529.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,062.00 / $13,091.56 / $23,039.20
| Facility | | $4,062.00 | $13,091.56 | $23,039.20 |