- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,566.70 / $20,085.80 / $23,157.80
| Facility | | $16,566.70 | $20,085.80 | $23,157.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,135.77 / $29,135.77 / $32,096.54
| Facility | | $29,135.77 | $29,135.77 | $32,096.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.00 / $3,456.00 / $5,462.00
| Facility | | $1,230.00 | $3,456.00 | $5,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,737.22 / $23,457.59 / $40,260.56
| Facility | | $14,737.22 | $23,457.59 | $40,260.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,137.00 / $22,962.76 / $35,448.10
| Facility | | $3,137.00 | $22,962.76 | $35,448.10 |