- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,022.40 / $29,349.10 / $41,555.10
| Facility | | $16,022.40 | $29,349.10 | $41,555.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,947.41 / $28,947.41 / $28,947.41
| Facility | | $28,947.41 | $28,947.41 | $28,947.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,215.90 / $29,531.56 / $46,742.20
| Facility | | $18,215.90 | $29,531.56 | $46,742.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,658.40 / $26,401.04 / $46,971.64
| Facility | | $16,658.40 | $26,401.04 | $46,971.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $24,909.36 / $55,544.05
| Facility | | $7,117.00 | $24,909.36 | $55,544.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $24,366.70 / $49,359.34
| Facility | | $3,308.00 | $24,366.70 | $49,359.34 |