- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,008.40 / $19,147.30 / $38,902.30
| Facility | | $10,008.40 | $19,147.30 | $38,902.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,267.67 / $29,267.67 / $31,096.35
| Facility | | $29,267.67 | $29,267.67 | $31,096.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,500.00 / $11,311.07 / $17,793.06
| Facility | | $7,500.00 | $11,311.07 | $17,793.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,500.00 / $11,278.41 / $31,096.35
| Facility | | $7,500.00 | $11,278.41 | $31,096.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,405.00 / $9,405.00 / $9,405.00
| Facility | | $9,405.00 | $9,405.00 | $9,405.00 |