- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,824.40 / $21,610.70 / $24,915.90
| Facility | | $17,824.40 | $21,610.70 | $24,915.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,282.82 / $39,282.82 / $39,282.82
| Facility | | $39,282.82 | $39,282.82 | $39,282.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,485.00 / $5,462.00
| Facility | | $1,252.00 | $3,485.00 | $5,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,856.04 / $25,238.44 / $43,317.06
| Facility | | $15,856.04 | $25,238.44 | $43,317.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $37,515.94
| Facility | | $2,332.00 | $5,310.00 | $37,515.94 |