- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,694.20 / $24,264.10 / $32,548.20
| Facility | | $11,694.20 | $24,264.10 | $32,548.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45,429.57 / $45,429.57 / $45,429.57
| Facility | | $45,429.57 | $45,429.57 | $45,429.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,897.00 / $28,981.58 / $34,460.44
| Facility | | $3,897.00 | $28,981.58 | $34,460.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,624.47 / $25,055.30 / $39,436.28
| Facility | | $20,624.47 | $25,055.30 | $39,436.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $30,955.16 / $39,094.18
| Facility | | $1,350.00 | $30,955.16 | $39,094.18 |