- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,760.30 / $21,541.50 / $37,906.80
| Facility | | $12,760.30 | $21,541.50 | $37,906.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,256.00 / $5,256.00 / $5,256.00
| Facility | | $5,256.00 | $5,256.00 | $5,256.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,685.69 / $21,500.48 / $34,751.91
| Facility | | $14,685.69 | $21,500.48 | $34,751.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,607.49 / $19,669.47 / $27,417.58
| Facility | | $11,607.49 | $19,669.47 | $27,417.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,726.15 / $39,726.15 / $46,622.01
| Facility | | $39,726.15 | $39,726.15 | $46,622.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $18,773.24 / $26,815.42
| Facility | | $1,787.00 | $18,773.24 | $26,815.42 |