- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,478.85 / $17,781.80 / $29,521.90
| Facility | | $11,478.85 | $17,781.80 | $29,521.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,641.90 / $16,641.90 / $16,641.90
| Facility | | $16,641.90 | $16,641.90 | $16,641.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,463.79 / $15,675.38 / $26,554.42
| Facility | | $10,463.79 | $15,675.38 | $26,554.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,327.32 / $18,966.30 / $27,271.23
| Facility | | $15,327.32 | $18,966.30 | $27,271.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,163.77 / $18,219.30 / $46,789.95
| Facility | | $9,163.77 | $18,219.30 | $46,789.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,226.00 / $18,179.66 / $25,550.62
| Facility | | $9,226.00 | $18,179.66 | $25,550.62 |