- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,064.00 / $23,742.40 / $41,779.69
| Facility | | $14,064.00 | $23,742.40 | $41,779.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,300.00 / $7,300.00 / $7,300.00
| Facility | | $7,300.00 | $7,300.00 | $7,300.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,807.02 / $17,428.32 / $28,574.53
| Facility | | $11,807.02 | $17,428.32 | $28,574.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,793.41 / $21,521.82 / $29,952.80
| Facility | | $12,793.41 | $21,521.82 | $29,952.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,751.50 / $43,751.50 / $51,346.10
| Facility | | $43,751.50 | $43,751.50 | $51,346.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $20,691.25 / $29,555.09
| Facility | | $1,787.00 | $20,691.25 | $29,555.09 |