- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,767.80 / $37,818.30 / $76,836.50
| Facility | | $19,767.80 | $37,818.30 | $76,836.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57,807.06 / $57,807.06 / $61,418.93
| Facility | | $57,807.06 | $57,807.06 | $61,418.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,500.00 / $22,340.69 / $35,725.94
| Facility | | $7,500.00 | $22,340.69 | $35,725.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,500.00 / $22,645.47 / $61,418.93
| Facility | | $7,500.00 | $22,645.47 | $61,418.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,577.00 / $18,577.00 / $18,577.00
| Facility | | $18,577.00 | $18,577.00 | $18,577.00 |