- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,292.50 / $41,201.80 / $56,997.90
| Facility | | $12,292.50 | $41,201.80 | $56,997.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $12,245.10
| Facility | | $1,146.00 | $3,000.00 | $12,245.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,507.80 / $21,427.06 / $39,744.11
| Facility | | $15,507.80 | $21,427.06 | $39,744.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,507.80 / $22,126.50 / $39,744.11
| Facility | | $15,507.80 | $22,126.50 | $39,744.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $27,424.57 / $42,522.22
| Facility | | $5,419.00 | $27,424.57 | $42,522.22 |