- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,405.70 / $20,670.50 / $26,803.20
| Facility | | $13,405.70 | $20,670.50 | $26,803.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,844.78 / $20,560.00 / $27,849.01
| Facility | | $11,844.78 | $20,560.00 | $27,849.01 |
- 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
- $10,174.00 / $14,784.00 / $22,805.00
| Facility | | $10,174.00 | $14,784.00 | $22,805.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,098.00 / $18,065.00 / $25,398.33
| Facility | | $6,098.00 | $18,065.00 | $25,398.33 |