- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,704.40 / $18,527.30 / $30,075.50
| Facility | | $12,704.40 | $18,527.30 | $30,075.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,403.30 / $29,403.30 / $29,403.30
| Facility | | $29,403.30 | $29,403.30 | $29,403.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,268.85 / $30,236.84 / $38,765.18
| Facility | | $21,268.85 | $30,236.84 | $38,765.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,917.95 / $28,842.46 / $36,480.49
| Facility | | $14,917.95 | $28,842.46 | $36,480.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,254.90 / $19,924.70 / $31,860.50
| Facility | | $13,254.90 | $19,924.70 | $31,860.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,501.49 / $26,507.73 / $40,272.94
| Facility | | $15,501.49 | $26,507.73 | $40,272.94 |