- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,080.00 / $70,655.60 / $97,743.70
| Facility | | $21,080.00 | $70,655.60 | $97,743.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $20,796.91
| Facility | | $1,146.00 | $3,000.00 | $20,796.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,593.81 / $36,744.55 / $68,155.86
| Facility | | $26,593.81 | $36,744.55 | $68,155.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,593.81 / $36,744.55 / $68,155.86
| Facility | | $26,593.81 | $36,744.55 | $68,155.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $47,029.48 / $72,919.94
| Facility | | $5,419.00 | $47,029.48 | $72,919.94 |