- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,694.24 / $14,247.10 / $21,996.30
| Facility | | $9,694.24 | $14,247.10 | $21,996.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,664.50 / $10,664.50 / $10,664.50
| Facility | | $10,664.50 | $10,664.50 | $10,664.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,251.38 / $33,055.32 / $42,378.61
| Facility | | $23,251.38 | $33,055.32 | $42,378.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,530.48 / $20,595.16 / $42,559.57
| Facility | | $10,530.48 | $20,595.16 | $42,559.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,694.24 / $14,572.30 / $23,301.80
| Facility | | $9,694.24 | $14,572.30 | $23,301.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.00 / $11,337.30 / $28,007.98
| Facility | | $1,288.00 | $11,337.30 | $28,007.98 |