- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,459.50 / $41,761.60 / $57,772.20
| Facility | | $12,459.50 | $41,761.60 | $57,772.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $5,899.25
| Facility | | $1,146.00 | $3,000.00 | $5,899.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,718.48 / $21,718.15 / $40,284.06
| Facility | | $15,718.48 | $21,718.15 | $40,284.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,718.48 / $22,427.10 / $40,284.06
| Facility | | $15,718.48 | $22,427.10 | $40,284.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $27,797.14 / $43,099.90
| Facility | | $5,419.00 | $27,797.14 | $43,099.90 |