- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,925.60 / $20,484.30 / $34,008.80
| Facility | | $12,925.60 | $20,484.30 | $34,008.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,760.24 / $19,760.24 / $19,760.24
| Facility | | $19,760.24 | $19,760.24 | $19,760.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,678.26 / $19,408.41 / $33,181.51
| Facility | | $12,678.26 | $19,408.41 | $33,181.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,656.83 / $22,391.55 / $39,107.06
| Facility | | $17,656.83 | $22,391.55 | $39,107.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,556.52 / $21,934.94 / $56,692.19
| Facility | | $10,556.52 | $21,934.94 | $56,692.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,556.52 / $20,942.68 / $29,433.91
| Facility | | $10,556.52 | $20,942.68 | $29,433.91 |