- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,720.30 / $22,148.30 / $38,751.19
| Facility | | $16,720.30 | $22,148.30 | $38,751.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,526.86 / $20,526.86 / $20,526.86
| Facility | | $20,526.86 | $20,526.86 | $20,526.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $18,892.93 / $36,837.78
| Facility | | $5,939.30 | $18,892.93 | $36,837.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,424.93 / $21,252.27 / $34,598.03
| Facility | | $14,424.93 | $21,252.27 | $34,598.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $22,824.91 / $39,206.90
| Facility | | $3,496.00 | $22,824.91 | $39,206.90 |