- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,429.10 / $20,706.50 / $26,849.90
| Facility | | $13,429.10 | $20,706.50 | $26,849.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,865.42 / $20,552.00 / $27,897.53
| Facility | | $11,865.42 | $20,552.00 | $27,897.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,817.00 / $4,817.00 / $4,817.00
| Facility | | $4,817.00 | $4,817.00 | $4,817.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,787.00 / $14,536.00 / $22,709.00
| Facility | | $9,787.00 | $14,536.00 | $22,709.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,098.00 / $18,065.00 / $25,442.59
| Facility | | $6,098.00 | $18,065.00 | $25,442.59 |