- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,859.80 / $22,532.60 / $30,225.60
| Facility | | $10,859.80 | $22,532.60 | $30,225.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,205.00 / $9,870.00 / $28,153.69
| Facility | | $2,205.00 | $9,870.00 | $28,153.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $990.00 / $990.00 / $1,365.00
| Facility | | $990.00 | $990.00 | $1,365.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,152.74 / $23,034.73 / $40,348.94
| Facility | | $19,152.74 | $23,034.73 | $40,348.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $340.00 / $1,103.00 / $15,678.12
| Facility | | $340.00 | $1,103.00 | $15,678.12 |