- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,326.51 / $21,325.10 / $34,336.10
| Facility | | $9,326.51 | $21,325.10 | $34,336.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,862.89 / $24,862.89 / $24,862.89
| Facility | | $24,862.89 | $24,862.89 | $24,862.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $11,054.38 / $29,656.51
| Facility | | $1,474.01 | $11,054.38 | $29,656.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,436.61 / $22,296.73 / $31,586.00
| Facility | | $15,436.61 | $22,296.73 | $31,586.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,668.80 / $18,245.20 / $38,623.44
| Facility | | $12,668.80 | $18,245.20 | $38,623.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,668.80 / $18,700.89 / $39,781.26
| Facility | | $12,668.80 | $18,700.89 | $39,781.26 |