- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,026.50 / $40,310.19 / $55,764.50
| Facility | | $12,026.50 | $40,310.19 | $55,764.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $37,187.71
| Facility | | $1,146.00 | $3,000.00 | $37,187.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,172.22 / $20,963.39 / $38,884.08
| Facility | | $15,172.22 | $20,963.39 | $38,884.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,172.22 / $20,963.39 / $38,884.08
| Facility | | $15,172.22 | $20,963.39 | $38,884.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $26,831.12 / $41,602.07
| Facility | | $5,419.00 | $26,831.12 | $41,602.07 |