- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,978.20 / $24,541.90 / $31,946.60
| Facility | | $15,978.20 | $24,541.90 | $31,946.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,117.76 / $24,506.00 / $33,193.15
| Facility | | $14,117.76 | $24,506.00 | $33,193.15 |
- 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
- $12,258.00 / $17,654.00 / $27,706.00
| Facility | | $12,258.00 | $17,654.00 | $27,706.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,098.00 / $18,065.00 / $30,272.20
| Facility | | $6,098.00 | $18,065.00 | $30,272.20 |