- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,962.50 / $43,447.50 / $60,104.50
| Facility | | $12,962.50 | $43,447.50 | $60,104.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $9,965.67
| Facility | | $1,146.00 | $3,000.00 | $9,965.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,353.05 / $22,594.93 / $41,910.36
| Facility | | $16,353.05 | $22,594.93 | $41,910.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,353.05 / $22,594.93 / $41,910.36
| Facility | | $16,353.05 | $22,594.93 | $41,910.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $28,919.34 / $44,839.88
| Facility | | $5,419.00 | $28,919.34 | $44,839.88 |