- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,451.00 / $28,074.00 / $51,379.60
| Facility | | $4,451.00 | $28,074.00 | $51,379.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,385.34 / $22,385.34 / $26,342.76
| Facility | | $22,385.34 | $22,385.34 | $26,342.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,089.25 / $25,447.75 / $40,146.29
| Facility | | $16,089.25 | $25,447.75 | $40,146.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,597.08 / $21,550.68 / $40,488.97
| Facility | | $10,597.08 | $21,550.68 | $40,488.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,377.79 / $30,246.87 / $44,936.00
| Facility | | $19,377.79 | $30,246.87 | $44,936.00 |