- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,736.90 / $18,097.40 / $23,466.60
| Facility | | $11,736.90 | $18,097.40 | $23,466.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,370.31 / $18,001.00 / $24,382.29
| Facility | | $10,370.31 | $18,001.00 | $24,382.29 |
- 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
- $8,817.00 / $12,638.00 / $19,884.00
| Facility | | $8,817.00 | $12,638.00 | $19,884.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,908.00 / $15,355.00 / $21,460.00
| Facility | | $4,908.00 | $15,355.00 | $21,460.00 |