- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,401.20 / $19,121.70 / $24,794.80
| Facility | | $12,401.20 | $19,121.70 | $24,794.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,957.26 / $19,020.00 / $25,762.30
| Facility | | $10,957.26 | $19,020.00 | $25,762.30 |
- 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
- $10,672.00 / $15,703.00 / $25,105.00
| Facility | | $10,672.00 | $15,703.00 | $25,105.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,098.00 / $18,065.00 / $23,495.25
| Facility | | $6,098.00 | $18,065.00 | $23,495.25 |