- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,287.00 / $51,238.70 / $70,882.80
| Facility | | $15,287.00 | $51,238.70 | $70,882.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $6,340.53
| Facility | | $1,146.00 | $3,000.00 | $6,340.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,285.56 / $26,646.77 / $49,425.93
| Facility | | $19,285.56 | $26,646.77 | $49,425.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,563.72 / $26,646.77 / $49,425.93
| Facility | | $17,563.72 | $26,646.77 | $49,425.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $35,177.10 / $52,880.79
| Facility | | $5,419.00 | $35,177.10 | $52,880.79 |