- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,098.00 / $17,051.00 / $60,645.90
| Facility | | $4,098.00 | $17,051.00 | $60,645.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,292.64 / $14,898.00 / $33,581.48
| Facility | | $4,292.64 | $14,898.00 | $33,581.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,133.39 / $56,585.14 / $78,873.17
| Facility | | $37,133.39 | $56,585.14 | $78,873.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,500.00 / $12,500.00 / $12,500.00
| Facility | | $12,500.00 | $12,500.00 | $12,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,411.00 / $23,505.00 / $67,922.80
| Facility | | $13,411.00 | $23,505.00 | $67,922.80 |