- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,335.50 / $17,380.70 / $20,039.00
| Facility | | $14,335.50 | $17,380.70 | $20,039.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,034.50 / $28,034.50 / $28,034.50
| Facility | | $28,034.50 | $28,034.50 | $28,034.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,485.00 / $5,462.00
| Facility | | $1,252.00 | $3,485.00 | $5,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,752.46 / $20,298.40 / $34,838.40
| Facility | | $12,752.46 | $20,298.40 | $34,838.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,137.00 / $20,261.02 / $30,674.06
| Facility | | $3,137.00 | $20,261.02 | $30,674.06 |