- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,508.30 / $26,892.10 / $35,005.80
| Facility | | $17,508.30 | $26,892.10 | $35,005.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,469.68 / $26,852.00 / $36,371.74
| Facility | | $15,469.68 | $26,852.00 | $36,371.74 |
- 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
- $12,668.00 / $18,831.00 / $28,580.00
| Facility | | $12,668.00 | $18,831.00 | $28,580.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,098.00 / $19,341.00 / $33,171.07
| Facility | | $6,098.00 | $19,341.00 | $33,171.07 |