- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $16,218.10 / $21,877.62
| Facility | | $6,309.57 | $16,218.10 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,498.45 / $19,952.62 / $30,902.95
| Facility | | $19,498.45 | $19,952.62 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $19,054.61 / $19,054.61
| Facility | | $19,054.61 | $19,054.61 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $16,982.44 / $23,988.33
| Facility | | $13,803.84 | $16,982.44 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $20,892.96 / $28,840.32
| Facility | | $2,041.74 | $20,892.96 | $28,840.32 |