- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,098.10 / $15,573.60 / $24,464.20
| Facility | | $11,098.10 | $15,573.60 | $24,464.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,020.08 / $13,020.08 / $13,020.08
| Facility | | $13,020.08 | $13,020.08 | $13,020.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,036.28 / $13,972.28 / $20,330.41
| Facility | | $9,036.28 | $13,972.28 | $20,330.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,681.64 / $13,366.08 / $24,192.00
| Facility | | $9,681.64 | $13,366.08 | $24,192.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.91 / $141.75 / $225.92
| Facility | | $102.91 | $141.75 | $225.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,663.83 / $14,758.33 / $24,288.77
| Facility | | $10,663.83 | $14,758.33 | $24,288.77 |