- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,726.40 / $18,940.30 / $31,699.40
| Facility | | $13,726.40 | $18,940.30 | $31,699.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,798.66 / $28,798.66 / $28,798.66
| Facility | | $28,798.66 | $28,798.66 | $28,798.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,272.00 / $22,648.37 / $34,170.01
| Facility | | $3,272.00 | $22,648.37 | $34,170.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,048.90 / $21,308.66 / $35,734.50
| Facility | | $14,048.90 | $21,308.66 | $35,734.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,062.00 / $21,729.17 / $38,240.12
| Facility | | $4,062.00 | $21,729.17 | $38,240.12 |