- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,457.50 / $26,251.90 / $35,812.30
| Facility | | $16,457.50 | $26,251.90 | $35,812.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,511.63 / $21,511.63 / $21,511.63
| Facility | | $21,511.63 | $21,511.63 | $21,511.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,805.60 / $23,723.87 / $35,942.17
| Facility | | $14,805.60 | $23,723.87 | $35,942.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,516.00 / $21,652.66 / $37,068.18
| Facility | | $7,516.00 | $21,652.66 | $37,068.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,516.00 / $22,998.07 / $35,079.32
| Facility | | $7,516.00 | $22,998.07 | $35,079.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,403.00 / $27,758.18 / $38,514.12
| Facility | | $10,403.00 | $27,758.18 | $38,514.12 |