- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,772.80 / $30,003.50 / $52,797.50
| Facility | | $17,772.80 | $30,003.50 | $52,797.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,256.00 / $5,256.00 / $5,256.00
| Facility | | $5,256.00 | $5,256.00 | $5,256.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,361.17 / $16,673.20 / $27,582.04
| Facility | | $11,361.17 | $16,673.20 | $27,582.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,703.55 / $27,197.37 / $37,317.19
| Facility | | $15,703.55 | $27,197.37 | $37,317.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55,398.25 / $55,398.25 / $65,014.55
| Facility | | $55,398.25 | $55,398.25 | $65,014.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $26,147.78 / $37,349.11
| Facility | | $1,787.00 | $26,147.78 | $37,349.11 |