- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,629.20 / $22,054.20 / $29,583.80
| Facility | | $10,629.20 | $22,054.20 | $29,583.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,834.79 / $23,148.24 / $40,034.92
| Facility | | $20,834.79 | $23,148.24 | $40,034.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,897.00 / $16,496.25 / $19,614.83
| Facility | | $3,897.00 | $16,496.25 | $19,614.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,746.09 / $22,773.40 / $35,844.64
| Facility | | $18,746.09 | $22,773.40 | $35,844.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $28,135.94 / $35,533.69
| Facility | | $1,350.00 | $28,135.94 | $35,533.69 |