- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,662.50 / $17,982.59 / $23,317.80
| Facility | | $11,662.50 | $17,982.59 | $23,317.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,304.52 / $17,848.00 / $24,227.60
| Facility | | $10,304.52 | $17,848.00 | $24,227.60 |
- 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
- $8,713.00 / $12,936.00 / $20,391.00
| Facility | | $8,713.00 | $12,936.00 | $20,391.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,098.00 / $18,065.00 / $22,095.61
| Facility | | $6,098.00 | $18,065.00 | $22,095.61 |