- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,437.50 / $33,695.40 / $58,954.30
| Facility | | $25,437.50 | $33,695.40 | $58,954.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,477.00 / $11,477.00 / $11,477.00
| Facility | | $11,477.00 | $11,477.00 | $11,477.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $26,783.42 / $56,829.30
| Facility | | $5,939.30 | $26,783.42 | $56,829.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,470.00 / $32,327.97 / $52,635.83
| Facility | | $17,470.00 | $32,327.97 | $52,635.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $34,724.76 / $53,037.77
| Facility | | $3,496.00 | $34,724.76 | $53,037.77 |