- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,607.50 / $25,508.40 / $33,204.80
| Facility | | $16,607.50 | $25,508.40 | $33,204.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,673.75 / $25,416.00 / $34,500.37
| Facility | | $14,673.75 | $25,416.00 | $34,500.37 |
- 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
- $12,281.00 / $18,281.00 / $28,953.00
| Facility | | $12,281.00 | $18,281.00 | $28,953.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,098.00 / $19,203.00 / $31,464.39
| Facility | | $6,098.00 | $19,203.00 | $31,464.39 |