- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,830.60 / $15,671.30 / $27,418.80
| Facility | | $11,830.60 | $15,671.30 | $27,418.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,731.33 / $17,731.33 / $17,731.33
| Facility | | $17,731.33 | $17,731.33 | $17,731.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $14,241.46 / $27,293.28
| Facility | | $5,939.30 | $14,241.46 | $27,293.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,854.38 / $15,916.60 / $24,480.23
| Facility | | $10,854.38 | $15,916.60 | $24,480.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $16,150.02 / $24,667.16
| Facility | | $3,496.00 | $16,150.02 | $24,667.16 |