- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,551.60 / $19,353.59 / $25,095.50
| Facility | | $12,551.60 | $19,353.59 | $25,095.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,090.13 / $19,250.00 / $26,074.70
| Facility | | $11,090.13 | $19,250.00 | $26,074.70 |
- 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
- $10,684.00 / $15,865.00 / $25,614.00
| Facility | | $10,684.00 | $15,865.00 | $25,614.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,098.00 / $18,764.00 / $23,780.16
| Facility | | $6,098.00 | $18,764.00 | $23,780.16 |