- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,740.75 / $30,270.00 / $50,203.80
| Facility | | $19,740.75 | $30,270.00 | $50,203.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,168.00 / $3,168.00 / $3,168.00
| Facility | | $3,168.00 | $3,168.00 | $3,168.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,947.12 / $26,319.46 / $45,074.57
| Facility | | $14,947.12 | $26,319.46 | $45,074.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,065.00 / $32,253.29 / $47,292.00
| Facility | | $26,065.00 | $32,253.29 | $47,292.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,583.52 / $32,512.54 / $51,907.04
| Facility | | $15,583.52 | $32,512.54 | $51,907.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,583.52 / $30,915.56 / $43,450.30
| Facility | | $15,583.52 | $30,915.56 | $43,450.30 |