- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,293.40 / $22,039.20 / $28,578.00
| Facility | | $14,293.40 | $22,039.20 | $28,578.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,629.10 / $21,922.00 / $29,693.07
| Facility | | $12,629.10 | $21,922.00 | $29,693.07 |
- 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
- $11,207.00 / $16,573.00 / $26,481.00
| Facility | | $11,207.00 | $16,573.00 | $26,481.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,098.00 / $18,065.00 / $27,080.12
| Facility | | $6,098.00 | $18,065.00 | $27,080.12 |