- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,266.40 / $23,376.30 / $31,357.20
| Facility | | $11,266.40 | $23,376.30 | $31,357.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,044.44 / $28,044.44 / $28,044.44
| Facility | | $28,044.44 | $28,044.44 | $28,044.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,897.00 / $58,714.55 / $69,814.32
| Facility | | $3,897.00 | $58,714.55 | $69,814.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,869.84 / $24,138.55 / $37,993.33
| Facility | | $19,869.84 | $24,138.55 | $37,993.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $29,837.79 / $48,942.82
| Facility | | $1,350.00 | $29,837.79 | $48,942.82 |