- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,639.80 / $20,157.59 / $40,965.50
| Facility | | $15,639.80 | $20,157.59 | $40,965.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,985.13 / $20,985.13 / $20,985.13
| Facility | | $20,985.13 | $20,985.13 | $20,985.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,690.68 / $20,922.12 / $23,919.39
| Facility | | $16,690.68 | $20,922.12 | $23,919.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,483.90 / $22,097.81 / $28,739.16
| Facility | | $12,483.90 | $22,097.81 | $28,739.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $19,173.25 / $28,228.46
| Facility | | $1,518.00 | $19,173.25 | $28,228.46 |