- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,884.80 / $17,332.00 / $28,135.30
| Facility | | $11,884.80 | $17,332.00 | $28,135.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,281.24 / $22,281.24 / $22,281.24
| Facility | | $22,281.24 | $22,281.24 | $22,281.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,148.46 / $40,017.24 / $51,304.16
| Facility | | $28,148.46 | $40,017.24 | $51,304.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,955.55 / $26,981.74 / $34,127.01
| Facility | | $13,955.55 | $26,981.74 | $34,127.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,399.80 / $18,639.30 / $29,805.10
| Facility | | $12,399.80 | $18,639.30 | $29,805.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,501.44 / $24,797.64 / $37,674.82
| Facility | | $14,501.44 | $24,797.64 | $37,674.82 |