- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,731.30 / $21,172.50 / $27,454.10
| Facility | | $13,731.30 | $21,172.50 | $27,454.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,132.45 / $21,060.00 / $28,525.37
| Facility | | $12,132.45 | $21,060.00 | $28,525.37 |
- 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
- $10,546.00 / $15,673.00 / $25,285.00
| Facility | | $10,546.00 | $15,673.00 | $25,285.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,098.00 / $18,065.00 / $26,015.17
| Facility | | $6,098.00 | $18,065.00 | $26,015.17 |