- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,071.00 / $25,442.40 / $44,771.20
| Facility | | $15,071.00 | $25,442.40 | $44,771.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,102.00 / $3,102.00 / $3,102.00
| Facility | | $3,102.00 | $3,102.00 | $3,102.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,004.45 / $25,160.52 / $41,219.86
| Facility | | $17,004.45 | $25,160.52 | $41,219.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,709.45 / $23,062.84 / $31,747.64
| Facility | | $13,709.45 | $23,062.84 | $31,747.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48,420.80 / $48,420.80 / $56,825.92
| Facility | | $48,420.80 | $48,420.80 | $56,825.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $22,172.80 / $31,671.31
| Facility | | $1,787.00 | $22,172.80 | $31,671.31 |