- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,134.04 / $18,952.00 / $25,422.50
| Facility | | $9,134.04 | $18,952.00 | $25,422.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,572.33 / $38,572.33 / $38,572.33
| Facility | | $38,572.33 | $38,572.33 | $38,572.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $17,561.55 / $20,881.50
| Facility | | $2,651.00 | $17,561.55 | $20,881.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,109.20 / $19,570.00 / $30,802.58
| Facility | | $16,109.20 | $19,570.00 | $30,802.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $24,178.22
| Facility | | $1,350.00 | $5,713.00 | $24,178.22 |