- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,122.30 / $21,903.50 / $34,488.60
| Facility | | $16,122.30 | $21,903.50 | $34,488.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,513.11 / $33,513.11 / $33,513.11
| Facility | | $33,513.11 | $33,513.11 | $33,513.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,121.27 / $19,729.34 / $29,210.12
| Facility | | $13,121.27 | $19,729.34 | $29,210.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,064.63 / $19,728.08 / $35,308.00
| Facility | | $14,064.63 | $19,728.08 | $35,308.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $140.40 / $205.93 / $328.19
| Facility | | $140.40 | $205.93 | $328.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,149.75 / $21,390.40 / $33,987.76
| Facility | | $15,149.75 | $21,390.40 | $33,987.76 |