- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,906.80 / $18,847.80 / $24,772.50
| Facility | | $12,906.80 | $18,847.80 | $24,772.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,350.91 / $11,849.16 / $20,041.25
| Facility | | $4,350.91 | $11,849.16 | $20,041.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,111.55 / $18,931.54 / $31,687.13
| Facility | | $13,111.55 | $18,931.54 | $31,687.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,235.01 / $21,127.85 / $30,848.39
| Facility | | $16,235.01 | $21,127.85 | $30,848.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,765.18 / $18,476.68 / $28,800.98
| Facility | | $10,765.18 | $18,476.68 | $28,800.98 |