- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,148.70 / $17,417.30 / $30,473.70
| Facility | | $13,148.70 | $17,417.30 | $30,473.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,738.23 / $14,631.64 / $22,262.75
| Facility | | $13,738.23 | $14,631.64 | $22,262.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $15,227.54 / $30,106.88
| Facility | | $5,939.30 | $15,227.54 | $30,106.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,063.72 / $17,470.00 / $27,207.68
| Facility | | $12,063.72 | $17,470.00 | $27,207.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $17,949.37 / $27,415.44
| Facility | | $3,496.00 | $17,949.37 | $27,415.44 |