- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,303.50 / $22,458.50 / $39,520.50
| Facility | | $13,303.50 | $22,458.50 | $39,520.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,225.77 / $21,225.77 / $24,105.03
| Facility | | $21,225.77 | $21,225.77 | $24,105.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,366.24 / $16,438.20 / $26,777.29
| Facility | | $11,366.24 | $16,438.20 | $26,777.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,101.62 / $20,430.56 / $28,584.75
| Facility | | $12,101.62 | $20,430.56 | $28,584.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44,255.00 / $44,255.00 / $51,937.00
| Facility | | $44,255.00 | $44,255.00 | $51,937.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $19,572.41 / $27,956.95
| Facility | | $1,787.00 | $19,572.41 | $27,956.95 |