- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,207.40 / $23,448.50 / $30,405.30
| Facility | | $15,207.40 | $23,448.50 | $30,405.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,436.64 / $23,274.00 / $31,591.73
| Facility | | $13,436.64 | $23,274.00 | $31,591.73 |
- 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
- $11,085.00 / $16,453.00 / $25,016.00
| Facility | | $11,085.00 | $16,453.00 | $25,016.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,098.00 / $18,065.00 / $28,811.70
| Facility | | $6,098.00 | $18,065.00 | $28,811.70 |