- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,215.40 / $29,062.50 / $51,141.60
| Facility | | $17,215.40 | $29,062.50 | $51,141.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,256.00 / $5,256.00 / $5,256.00
| Facility | | $5,256.00 | $5,256.00 | $5,256.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,677.77 / $7,959.89 / $13,087.93
| Facility | | $5,677.77 | $7,959.89 | $13,087.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,211.04 / $25,911.54 / $36,146.82
| Facility | | $15,211.04 | $25,911.54 | $36,146.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58,204.60 / $58,204.60 / $68,308.03
| Facility | | $58,204.60 | $58,204.60 | $68,308.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $23,690.00 / $36,177.72
| Facility | | $1,787.00 | $23,690.00 | $36,177.72 |