- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,374.00 / $26,685.80 / $34,737.30
| Facility | | $17,374.00 | $26,685.80 | $34,737.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,351.00 / $26,646.00 / $36,092.69
| Facility | | $15,351.00 | $26,646.00 | $36,092.69 |
- 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
- $12,146.00 / $18,281.00 / $28,057.00
| Facility | | $12,146.00 | $18,281.00 | $28,057.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,909.00 / $12,823.44 / $32,015.76
| Facility | | $6,909.00 | $12,823.44 | $32,015.76 |