- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,307.80 / $24,621.70 / $28,387.40
| Facility | | $20,307.80 | $24,621.70 | $28,387.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41,488.60 / $41,488.60 / $41,488.60
| Facility | | $41,488.60 | $41,488.60 | $41,488.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,715.00 / $8,731.00
| Facility | | $1,252.00 | $3,715.00 | $8,731.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,065.25 / $28,754.91 / $49,352.42
| Facility | | $18,065.25 | $28,754.91 | $49,352.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,137.00 / $27,982.46 / $43,453.18
| Facility | | $3,137.00 | $27,982.46 | $43,453.18 |