- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,284.70 / $23,567.80 / $30,560.10
| Facility | | $15,284.70 | $23,567.80 | $30,560.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,505.01 / $23,442.00 / $31,752.48
| Facility | | $13,505.01 | $23,442.00 | $31,752.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,817.00 / $4,817.00 / $4,817.00
| Facility | | $4,817.00 | $4,817.00 | $4,817.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,549.00 / $19,797.00 / $32,277.00
| Facility | | $13,549.00 | $19,797.00 | $32,277.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,098.00 / $18,764.00 / $28,958.30
| Facility | | $6,098.00 | $18,764.00 | $28,958.30 |