- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,905.27 / $14,199.80 / $23,574.90
| Facility | | $10,905.27 | $14,199.80 | $23,574.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,344.00 / $25,344.00 / $25,344.00
| Facility | | $25,344.00 | $25,344.00 | $25,344.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,312.61 / $12,725.29 / $21,095.28
| Facility | | $8,312.61 | $12,725.29 | $21,095.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,239.74 / $15,145.67 / $21,777.63
| Facility | | $12,239.74 | $15,145.67 | $21,777.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,608.75 / $15,205.33 / $37,170.72
| Facility | | $7,608.75 | $15,205.33 | $37,170.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,608.75 / $14,517.50 / $20,403.62
| Facility | | $7,608.75 | $14,517.50 | $20,403.62 |