- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,208.59 / $23,288.90 / $26,850.80
| Facility | | $19,208.59 | $23,288.90 | $26,850.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,685.51 / $40,685.51 / $40,685.51
| Facility | | $40,685.51 | $40,685.51 | $40,685.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,715.00 / $14,552.00
| Facility | | $1,252.00 | $3,715.00 | $14,552.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,792.77 / $26,897.89 / $46,680.95
| Facility | | $16,792.77 | $26,897.89 | $46,680.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,137.00 / $27,148.31 / $41,101.04
| Facility | | $3,137.00 | $27,148.31 | $41,101.04 |