- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,644.50 / $23,034.10 / $40,533.40
| Facility | | $13,644.50 | $23,034.10 | $40,533.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,439.67 / $11,439.67 / $11,439.67
| Facility | | $11,439.67 | $11,439.67 | $11,439.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,159.15 / $20,900.30 / $34,557.48
| Facility | | $14,159.15 | $20,900.30 | $34,557.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,411.79 / $20,908.28 / $29,205.07
| Facility | | $12,411.79 | $20,908.28 | $29,205.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,866.40 / $42,866.40 / $50,307.36
| Facility | | $42,866.40 | $42,866.40 | $50,307.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,520.00 / $19,546.68 / $28,520.00
| Facility | | $2,520.00 | $19,546.68 | $28,520.00 |