- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,465.00 / $37,265.60 / $50,007.50
| Facility | | $22,465.00 | $37,265.60 | $50,007.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,283.40 / $10,283.40 / $10,283.40
| Facility | | $10,283.40 | $10,283.40 | $10,283.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,441.09 / $30,300.52 / $48,482.00
| Facility | | $17,441.09 | $30,300.52 | $48,482.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,446.77 / $30,004.50 / $68,812.32
| Facility | | $18,446.77 | $30,004.50 | $68,812.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,771.27 / $29,446.42 / $41,870.28
| Facility | | $21,771.27 | $29,446.42 | $41,870.28 |