- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,633.60 / $22,563.80 / $29,258.10
| Facility | | $14,633.60 | $22,563.80 | $29,258.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,929.67 / $22,444.00 / $30,399.76
| Facility | | $12,929.67 | $22,444.00 | $30,399.76 |
- 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
- $11,577.00 / $16,837.00 / $26,032.00
| Facility | | $11,577.00 | $16,837.00 | $26,032.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,098.00 / $18,065.00 / $27,724.62
| Facility | | $6,098.00 | $18,065.00 | $27,724.62 |