- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,420.50 / $23,777.20 / $30,831.50
| Facility | | $15,420.50 | $23,777.20 | $30,831.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,455.13 / $22,455.13 / $22,455.13
| Facility | | $22,455.13 | $22,455.13 | $22,455.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,173.87 / $7,173.87 / $7,173.87
| Facility | | $7,173.87 | $7,173.87 | $7,173.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,624.98 / $23,650.00 / $32,034.55
| Facility | | $13,624.98 | $23,650.00 | $32,034.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,817.00 / $4,817.00 / $4,817.00
| Facility | | $4,817.00 | $4,817.00 | $4,817.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,460.00 / $16,863.00 / $26,676.00
| Facility | | $11,460.00 | $16,863.00 | $26,676.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,098.00 / $18,065.00 / $29,215.55
| Facility | | $6,098.00 | $18,065.00 | $29,215.55 |