- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,717.20 / $28,748.80 / $37,422.90
| Facility | | $18,717.20 | $28,748.80 | $37,422.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,537.80 / $28,707.00 / $38,883.06
| Facility | | $16,537.80 | $28,707.00 | $38,883.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,817.00 / $4,817.00 / $4,817.00
| Facility | | $4,817.00 | $4,817.00 | $4,817.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,247.00 / $21,004.00 / $32,349.00
| Facility | | $14,247.00 | $21,004.00 | $32,349.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,098.00 / $18,764.00 / $35,461.40
| Facility | | $6,098.00 | $18,764.00 | $35,461.40 |