- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,784.40 / $27,842.50 / $37,362.50
| Facility | | $16,784.40 | $27,842.50 | $37,362.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,708.11 / $14,708.11 / $14,708.11
| Facility | | $14,708.11 | $14,708.11 | $14,708.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,930.57 / $24,398.43 / $39,038.43
| Facility | | $13,930.57 | $24,398.43 | $39,038.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,273.79 / $22,417.50 / $51,412.29
| Facility | | $15,273.79 | $22,417.50 | $51,412.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,266.14 / $22,000.53 / $31,835.84
| Facility | | $16,266.14 | $22,000.53 | $31,835.84 |