- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,724.60 / $42,807.10 / $55,722.70
| Facility | | $26,724.60 | $42,807.10 | $55,722.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,624.81 / $42,652.00 / $57,896.94
| Facility | | $24,624.81 | $42,652.00 | $57,896.94 |
- 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
- $19,109.00 / $29,798.00 / $46,552.00
| Facility | | $19,109.00 | $29,798.00 | $46,552.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,098.00 / $19,347.00 / $52,802.08
| Facility | | $6,098.00 | $19,347.00 | $52,802.08 |