- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,936.80 / $14,472.50 / $16,685.90
| Facility | | $11,936.80 | $14,472.50 | $16,685.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,575.66 / $14,575.66 / $14,575.66
| Facility | | $14,575.66 | $14,575.66 | $14,575.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,702.00 / $6,578.00
| Facility | | $1,252.00 | $3,702.00 | $6,578.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,618.64 / $16,901.95 / $29,009.03
| Facility | | $10,618.64 | $16,901.95 | $29,009.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $25,124.07
| Facility | | $2,332.00 | $5,310.00 | $25,124.07 |