- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,357.50 / $29,615.60 / $51,816.10
| Facility | | $22,357.50 | $29,615.60 | $51,816.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,396.00 / $12,396.00 / $12,396.00
| Facility | | $12,396.00 | $12,396.00 | $12,396.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $23,337.07 / $47,708.88
| Facility | | $5,939.30 | $23,337.07 | $47,708.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,860.18 / $28,413.71 / $46,262.70
| Facility | | $16,860.18 | $28,413.71 | $46,262.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $28,222.00 / $52,425.45
| Facility | | $3,496.00 | $28,222.00 | $52,425.45 |