- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,641.00 / $17,442.50 / $29,192.60
| Facility | | $12,641.00 | $17,442.50 | $29,192.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,730.72 / $24,730.72 / $24,730.72
| Facility | | $24,730.72 | $24,730.72 | $24,730.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,494.00 / $18,591.03 / $28,801.01
| Facility | | $3,494.00 | $18,591.03 | $28,801.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,782.00 / $19,623.57 / $32,908.61
| Facility | | $12,782.00 | $19,623.57 | $32,908.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,062.00 / $20,024.87 / $35,216.08
| Facility | | $4,062.00 | $20,024.87 | $35,216.08 |