- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,041.20 / $27,710.60 / $36,071.30
| Facility | | $18,041.20 | $27,710.60 | $36,071.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,940.53 / $27,670.00 / $37,478.78
| Facility | | $15,940.53 | $27,670.00 | $37,478.78 |
- 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
- $12,693.00 / $20,387.00 / $31,867.00
| Facility | | $12,693.00 | $20,387.00 | $31,867.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,098.00 / $19,341.00 / $34,180.69
| Facility | | $6,098.00 | $19,341.00 | $34,180.69 |