- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,937.60 / $18,464.59 / $32,492.30
| Facility | | $10,937.60 | $18,464.59 | $32,492.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,613.88 / $16,613.88 / $18,214.97
| Facility | | $16,613.88 | $16,613.88 | $18,214.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,919.19 / $14,676.86 / $24,044.74
| Facility | | $9,919.19 | $14,676.86 | $24,044.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,949.50 / $17,019.81 / $23,501.30
| Facility | | $9,949.50 | $17,019.81 | $23,501.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,360.85 / $33,360.85 / $39,151.79
| Facility | | $33,360.85 | $33,360.85 | $39,151.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $16,091.70 / $22,985.15
| Facility | | $1,787.00 | $16,091.70 | $22,985.15 |