- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,642.00 / $28,491.10 / $28,491.10
| Facility | | $25,642.00 | $28,491.10 | $28,491.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,433.98 / $12,433.98 / $41,233.78
| Facility | | $12,433.98 | $12,433.98 | $41,233.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,835.34 / $22,838.12 / $37,607.33
| Facility | | $9,835.34 | $22,838.12 | $37,607.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,781.18 / $31,369.61 / $49,299.54
| Facility | | $17,781.18 | $31,369.61 | $49,299.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $42,564.98 / $54,958.52
| Facility | | $6,965.00 | $42,564.98 | $54,958.52 |