- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,036.80 / $27,703.80 / $36,062.60
| Facility | | $18,036.80 | $27,703.80 | $36,062.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,760.00 / $34,822.10 / $103,121.39
| Facility | | $12,760.00 | $34,822.10 | $103,121.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,936.66 / $27,663.00 / $37,469.68
| Facility | | $15,936.66 | $27,663.00 | $37,469.68 |
- 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
- $14,129.00 / $20,425.00 / $32,059.00
| Facility | | $14,129.00 | $20,425.00 | $32,059.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,098.00 / $18,764.00 / $34,172.40
| Facility | | $6,098.00 | $18,764.00 | $34,172.40 |