- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,993.50 / $36,847.80 / $50,974.70
| Facility | | $10,993.50 | $36,847.80 | $50,974.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $13,741.94
| Facility | | $1,146.00 | $3,000.00 | $13,741.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,869.03 / $19,162.77 / $35,544.18
| Facility | | $13,869.03 | $19,162.77 | $35,544.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,869.03 / $19,623.59 / $35,544.18
| Facility | | $13,869.03 | $19,623.59 | $35,544.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $24,526.50 / $38,028.72
| Facility | | $5,419.00 | $24,526.50 | $38,028.72 |