- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,839.60 / $23,029.20 / $36,866.40
| Facility | | $14,839.60 | $23,029.20 | $36,866.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,141.29 / $15,141.29 / $15,141.29
| Facility | | $15,141.29 | $15,141.29 | $15,141.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,231.64 / $18,096.09 / $25,485.28
| Facility | | $9,231.64 | $18,096.09 | $25,485.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,712.82 / $18,371.14 / $32,188.68
| Facility | | $13,712.82 | $18,371.14 | $32,188.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,464.88 / $20,318.95 / $27,879.99
| Facility | | $13,464.88 | $20,318.95 | $27,879.99 |