- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,946.10 / $24,492.60 / $31,882.40
| Facility | | $15,946.10 | $24,492.60 | $31,882.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,089.38 / $24,348.41 / $33,126.43
| Facility | | $14,089.38 | $24,348.41 | $33,126.43 |
- 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
- $12,648.00 / $18,970.00 / $30,313.00
| Facility | | $12,648.00 | $18,970.00 | $30,313.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,909.00 / $16,813.00 / $29,384.55
| Facility | | $6,909.00 | $16,813.00 | $29,384.55 |