- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,629.70 / $18,949.90 / $21,848.10
| Facility | | $15,629.70 | $18,949.90 | $21,848.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,892.57 / $22,053.05 / $38,503.71
| Facility | | $18,892.57 | $22,053.05 | $38,503.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,702.00 / $6,578.00
| Facility | | $1,252.00 | $3,702.00 | $6,578.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,903.76 / $22,130.95 / $37,983.62
| Facility | | $13,903.76 | $22,130.95 | $37,983.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,137.00 / $21,880.07 / $33,443.33
| Facility | | $3,137.00 | $21,880.07 | $33,443.33 |