- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,940.20 / $26,413.50 / $46,213.70
| Facility | | $19,940.20 | $26,413.50 | $46,213.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,000.00 / $6,000.00 / $6,000.00
| Facility | | $6,000.00 | $6,000.00 | $6,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $23,359.68 / $47,755.09
| Facility | | $5,939.30 | $23,359.68 | $47,755.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,037.24 / $25,341.59 / $41,260.73
| Facility | | $15,037.24 | $25,341.59 | $41,260.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $27,220.41 / $41,575.81
| Facility | | $3,496.00 | $27,220.41 | $41,575.81 |