- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,774.89 / $21,040.70 / $34,932.50
| Facility | | $14,774.89 | $21,040.70 | $34,932.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,131.00 / $10,131.00 / $10,131.00
| Facility | | $10,131.00 | $10,131.00 | $10,131.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,722.21 / $21,006.53 / $36,427.49
| Facility | | $13,722.21 | $21,006.53 | $36,427.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,210.00 / $21,486.25 / $38,099.00
| Facility | | $17,210.00 | $21,486.25 | $38,099.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,274.38 / $21,511.51 / $36,117.69
| Facility | | $11,274.38 | $21,511.51 | $36,117.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,843.24 / $20,838.65 / $30,233.36
| Facility | | $10,843.24 | $20,838.65 | $30,233.36 |