- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,055.60 / $24,660.80 / $32,101.30
| Facility | | $16,055.60 | $24,660.80 | $32,101.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,186.13 / $24,572.00 / $33,353.90
| Facility | | $14,186.13 | $24,572.00 | $33,353.90 |
- 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
- $10,914.00 / $17,806.00 / $28,784.00
| Facility | | $10,914.00 | $17,806.00 | $28,784.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,098.00 / $18,887.34 / $30,418.80
| Facility | | $6,098.00 | $18,887.34 | $30,418.80 |