- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,928.30 / $19,934.40 / $25,848.60
| Facility | | $12,928.30 | $19,934.40 | $25,848.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,422.95 / $19,828.00 / $26,857.22
| Facility | | $11,422.95 | $19,828.00 | $26,857.22 |
- 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
- $9,434.00 / $14,080.00 / $22,337.00
| Facility | | $9,434.00 | $14,080.00 | $22,337.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,098.00 / $18,065.00 / $24,493.82
| Facility | | $6,098.00 | $18,065.00 | $24,493.82 |