- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $20,892.96 / $63,095.73
| Facility | | $16,982.44 | $20,892.96 | $63,095.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44,668.36 / $44,668.36 / $47,863.01
| Facility | | $44,668.36 | $44,668.36 | $47,863.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $12,022.64 / $20,892.96
| Facility | | $12,022.64 | $12,022.64 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $17,378.01 / $26,302.68
| Facility | | $10,000.00 | $17,378.01 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44,668.36 / $44,668.36 / $47,863.01
| Facility | | $44,668.36 | $44,668.36 | $47,863.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $5,754.40 / $5,754.40
| Facility | | $5,754.40 | $5,754.40 | $5,754.40 |