- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,408.50 / $41,590.60 / $57,535.70
| Facility | | $12,408.50 | $41,590.60 | $57,535.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $13,228.11
| Facility | | $1,146.00 | $3,000.00 | $13,228.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,654.14 / $21,629.26 / $40,119.16
| Facility | | $15,654.14 | $21,629.26 | $40,119.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,654.14 / $22,335.30 / $40,119.16
| Facility | | $15,654.14 | $22,335.30 | $40,119.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $31,356.35 / $42,923.48
| Facility | | $5,419.00 | $31,356.35 | $42,923.48 |