- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,743.30 / $25,717.00 / $33,476.19
| Facility | | $16,743.30 | $25,717.00 | $33,476.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,330.40 / $25,091.33 / $34,612.72
| Facility | | $13,330.40 | $25,091.33 | $34,612.72 |
- 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
- $12,925.00 / $18,206.00 / $27,872.00
| Facility | | $12,925.00 | $18,206.00 | $27,872.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,086.00 / $10,541.33 / $29,727.35
| Facility | | $3,086.00 | $10,541.33 | $29,727.35 |