- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,073.50 / $25,446.60 / $44,778.70
| Facility | | $15,073.50 | $25,446.60 | $44,778.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,256.00 / $5,256.00 / $5,256.00
| Facility | | $5,256.00 | $5,256.00 | $5,256.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,821.72 / $20,567.96 / $33,555.62
| Facility | | $13,821.72 | $20,567.96 | $33,555.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,711.73 / $23,066.67 / $31,752.11
| Facility | | $13,711.73 | $23,066.67 | $31,752.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $49,971.05 / $49,971.05 / $58,645.27
| Facility | | $49,971.05 | $49,971.05 | $58,645.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $22,176.49 / $31,676.58
| Facility | | $1,787.00 | $22,176.49 | $31,676.58 |