- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,665.00 / $28,698.20 / $50,211.00
| Facility | | $21,665.00 | $28,698.20 | $50,211.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,870.00 / $23,870.00 / $23,870.00
| Facility | | $23,870.00 | $23,870.00 | $23,870.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,707.53 / $23,927.08 / $54,708.90
| Facility | | $5,707.53 | $23,927.08 | $54,708.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,337.93 / $27,533.57 / $44,829.68
| Facility | | $16,337.93 | $27,533.57 | $44,829.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $29,574.91 / $45,172.01
| Facility | | $3,496.00 | $29,574.91 | $45,172.01 |