- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,807.40 / $16,740.40 / $19,300.70
| Facility | | $13,807.40 | $16,740.40 | $19,300.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,533.68 / $33,533.68 / $33,533.68
| Facility | | $33,533.68 | $33,533.68 | $33,533.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,715.00 / $22,000.00
| Facility | | $1,252.00 | $3,715.00 | $22,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,282.66 / $19,550.61 / $33,554.96
| Facility | | $12,282.66 | $19,550.61 | $33,554.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,137.00 / $19,362.71 / $29,544.03
| Facility | | $3,137.00 | $19,362.71 | $29,544.03 |