- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,369.40 / $21,515.10 / $28,860.70
| Facility | | $10,369.40 | $21,515.10 | $28,860.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,446.22 / $30,446.22 / $30,446.22
| Facility | | $30,446.22 | $30,446.22 | $30,446.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,897.00 / $19,863.73 / $23,618.90
| Facility | | $3,897.00 | $19,863.73 | $23,618.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,287.84 / $22,216.70 / $34,968.41
| Facility | | $18,287.84 | $22,216.70 | $34,968.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $27,448.15 / $34,665.07
| Facility | | $1,350.00 | $27,448.15 | $34,665.07 |