- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,294.80 / $22,521.10 / $31,887.50
| Facility | | $12,294.80 | $22,521.10 | $31,887.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,462.87 / $29,462.87 / $29,462.87
| Facility | | $29,462.87 | $29,462.87 | $29,462.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,358.50 / $19,732.40 / $31,109.25
| Facility | | $12,358.50 | $19,732.40 | $31,109.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,782.88 / $20,258.93 / $36,043.85
| Facility | | $12,782.88 | $20,258.93 | $36,043.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $19,306.05 / $42,621.92
| Facility | | $7,117.00 | $19,306.05 | $42,621.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $18,697.87 / $37,876.06
| Facility | | $3,308.00 | $18,697.87 | $37,876.06 |