- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,749.11 / $11,393.60 / $20,049.50
| Facility | | $6,749.11 | $11,393.60 | $20,049.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,848.68 / $16,052.17 / $26,477.77
| Facility | | $10,848.68 | $16,052.17 | $26,477.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,139.38 / $10,502.14 / $15,118.27
| Facility | | $6,139.38 | $10,502.14 | $15,118.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,488.85 / $21,488.85 / $39,000.00
| Facility | | $21,488.85 | $21,488.85 | $39,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $9,929.44 / $14,183.07
| Facility | | $1,787.00 | $9,929.44 | $14,183.07 |