- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,765.80 / $23,383.90 / $33,109.10
| Facility | | $12,765.80 | $23,383.90 | $33,109.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,001.71 / $19,001.71 / $19,001.71
| Facility | | $19,001.71 | $19,001.71 | $19,001.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,962.49 / $20,545.62 / $32,612.82
| Facility | | $12,962.49 | $20,545.62 | $32,612.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,272.60 / $21,035.06 / $37,424.71
| Facility | | $13,272.60 | $21,035.06 | $37,424.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $19,818.59 / $44,254.79
| Facility | | $7,117.00 | $19,818.59 | $44,254.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $19,414.18 / $39,327.12
| Facility | | $3,308.00 | $19,414.18 | $39,327.12 |