- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,498.45 / $22,908.68 / $29,512.09
| Facility | | $19,498.45 | $22,908.68 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $22,908.68 / $26,302.68
| Facility | | $22,908.68 | $22,908.68 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $23,988.33 / $40,738.03
| Facility | | $10,000.00 | $23,988.33 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151,356.12 / $151,356.12 / $151,356.12
| Facility | | $151,356.12 | $151,356.12 | $151,356.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $23,988.33 / $40,738.03
| Facility | | $9,772.37 | $23,988.33 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $24,547.09 / $39,810.72
| Facility | | $13,182.57 | $24,547.09 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $23,442.29 / $34,673.69
| Facility | | $15,488.17 | $23,442.29 | $34,673.69 |