- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,796.50 / $26,551.20 / $35,616.10
| Facility | | $12,796.50 | $26,551.20 | $35,616.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,874.97 / $19,874.97 / $19,874.97
| Facility | | $19,874.97 | $19,874.97 | $19,874.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $28,822.81 / $34,271.66
| Facility | | $2,651.00 | $28,822.81 | $34,271.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,568.52 / $27,417.00 / $43,153.52
| Facility | | $22,568.52 | $27,417.00 | $43,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $33,872.98
| Facility | | $1,350.00 | $5,713.00 | $33,872.98 |