- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,367.36 / $15,813.70 / $27,827.50
| Facility | | $9,367.36 | $15,813.70 | $27,827.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,312.06 / $14,312.06 / $14,312.06
| Facility | | $14,312.06 | $14,312.06 | $14,312.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,738.95 / $9,866.11 / $16,313.06
| Facility | | $6,738.95 | $9,866.11 | $16,313.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,521.08 / $14,576.33 / $20,127.30
| Facility | | $8,521.08 | $14,576.33 | $20,127.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,726.75 / $30,726.75 / $36,060.44
| Facility | | $30,726.75 | $30,726.75 | $36,060.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $13,781.47 / $19,685.25
| Facility | | $1,787.00 | $13,781.47 | $19,685.25 |