- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,537.20 / $15,366.80 / $24,945.10
| Facility | | $10,537.20 | $15,366.80 | $24,945.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,350.11 / $17,350.11 / $22,397.71
| Facility | | $17,350.11 | $17,350.11 | $22,397.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,069.93 / $35,640.65 / $45,693.14
| Facility | | $25,069.93 | $35,640.65 | $45,693.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,373.15 / $23,922.32 / $30,257.41
| Facility | | $12,373.15 | $23,922.32 | $30,257.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,993.80 / $16,525.80 / $26,425.50
| Facility | | $10,993.80 | $16,525.80 | $26,425.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,648.75 / $21,985.87 / $33,402.92
| Facility | | $13,648.75 | $21,985.87 | $33,402.92 |