- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,609.60 / $34,727.40 / $45,205.20
| Facility | | $22,609.60 | $34,727.40 | $45,205.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,000.93 / $33,882.49 / $46,739.85
| Facility | | $18,000.93 | $33,882.49 | $46,739.85 |
- 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
- $14,846.00 / $24,218.00 / $36,742.00
| Facility | | $14,846.00 | $24,218.00 | $36,742.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,630.00 / $6,909.00 / $41,663.53
| Facility | | $1,630.00 | $6,909.00 | $41,663.53 |