- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,760.50 / $16,373.90 / $27,184.60
| Facility | | $12,760.50 | $16,373.90 | $27,184.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,974.00 / $9,974.00 / $9,974.00
| Facility | | $9,974.00 | $9,974.00 | $9,974.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,770.37 / $14,956.90 / $31,203.41
| Facility | | $9,770.37 | $14,956.90 | $31,203.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,113.81 / $18,243.78 / $35,446.00
| Facility | | $14,113.81 | $18,243.78 | $35,446.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,773.75 / $17,533.46 / $43,689.28
| Facility | | $8,773.75 | $17,533.46 | $43,689.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,773.75 / $16,740.32 / $23,527.69
| Facility | | $8,773.75 | $16,740.32 | $23,527.69 |