- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.10 / $16,145.60 / $20,935.80
| Facility | | $10,471.10 | $16,145.60 | $20,935.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,251.87 / $16,060.00 / $21,752.68
| Facility | | $9,251.87 | $16,060.00 | $21,752.68 |
- 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
- $8,431.00 / $12,600.00 / $20,455.00
| Facility | | $8,431.00 | $12,600.00 | $20,455.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,098.00 / $18,065.00 / $19,838.47
| Facility | | $6,098.00 | $18,065.00 | $19,838.47 |