- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,774.00 / $27,300.20 / $35,537.10
| Facility | | $17,774.00 | $27,300.20 | $35,537.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,704.46 / $27,260.00 / $36,923.74
| Facility | | $15,704.46 | $27,260.00 | $36,923.74 |
- 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
- $13,686.00 / $19,800.00 / $31,064.00
| Facility | | $13,686.00 | $19,800.00 | $31,064.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,098.00 / $18,764.00 / $33,674.50
| Facility | | $6,098.00 | $18,764.00 | $33,674.50 |