- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,855.10 / $16,568.50 / $33,671.50
| Facility | | $12,855.10 | $16,568.50 | $33,671.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,278.01 / $14,278.01 / $44,163.37
| Facility | | $14,278.01 | $14,278.01 | $44,163.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,215.94 / $16,566.46 / $18,939.75
| Facility | | $13,215.94 | $16,566.46 | $18,939.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,261.11 / $18,163.24 / $23,622.08
| Facility | | $10,261.11 | $18,163.24 | $23,622.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50,787.88 / $50,787.88 / $50,787.88
| Facility | | $50,787.88 | $50,787.88 | $50,787.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,000.00 / $18,844.91 / $25,546.93
| Facility | | $2,000.00 | $18,844.91 | $25,546.93 |