- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,767.70 / $16,455.80 / $33,442.50
| Facility | | $12,767.70 | $16,455.80 | $33,442.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,025.55 / $18,025.55 / $18,025.55
| Facility | | $18,025.55 | $18,025.55 | $18,025.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,319.21 / $15,442.39 / $17,654.64
| Facility | | $12,319.21 | $15,442.39 | $17,654.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,191.32 / $18,039.71 / $23,461.43
| Facility | | $10,191.32 | $18,039.71 | $23,461.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,840.05 / $18,840.05 / $18,840.05
| Facility | | $18,840.05 | $18,840.05 | $18,840.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $16,391.64 / $23,044.51
| Facility | | $1,518.00 | $16,391.64 | $23,044.51 |