- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,024.40 / $21,987.30 / $38,691.30
| Facility | | $13,024.40 | $21,987.30 | $38,691.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,173.76 / $11,173.76 / $11,173.76
| Facility | | $11,173.76 | $11,173.76 | $11,173.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,002.88 / $17,759.99 / $29,379.89
| Facility | | $12,002.88 | $17,759.99 | $29,379.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,847.72 / $20,039.48 / $27,985.00
| Facility | | $11,847.72 | $20,039.48 | $27,985.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41,870.00 / $41,870.00 / $49,138.00
| Facility | | $41,870.00 | $41,870.00 | $49,138.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $19,161.75 / $27,370.38
| Facility | | $1,787.00 | $19,161.75 | $27,370.38 |