- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,756.84 / $16,094.50 / $21,589.30
| Facility | | $7,756.84 | $16,094.50 | $21,589.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,653.76 / $35,653.76 / $35,653.76
| Facility | | $35,653.76 | $35,653.76 | $35,653.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $11,766.76 / $13,991.22
| Facility | | $2,651.00 | $11,766.76 | $13,991.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,680.31 / $16,619.30 / $26,158.27
| Facility | | $13,680.31 | $16,619.30 | $26,158.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $20,532.71
| Facility | | $1,350.00 | $5,713.00 | $20,532.71 |