- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,630.40 / $24,269.30 / $32,567.50
| Facility | | $14,630.40 | $24,269.30 | $32,567.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,131.20 / $17,131.20 / $17,131.20
| Facility | | $17,131.20 | $17,131.20 | $17,131.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,559.29 / $20,366.52 / $31,491.51
| Facility | | $11,559.29 | $20,366.52 | $31,491.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,013.50 / $19,540.50 / $44,814.18
| Facility | | $12,013.50 | $19,540.50 | $44,814.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,263.26 / $19,177.05 / $27,604.21
| Facility | | $14,263.26 | $19,177.05 | $27,604.21 |