- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,773.20 / $17,169.30 / $27,871.10
| Facility | | $11,773.20 | $17,169.30 | $27,871.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,022.78 / $9,022.78 / $9,022.78
| Facility | | $9,022.78 | $9,022.78 | $9,022.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,917.50 / $36,845.58 / $47,237.94
| Facility | | $25,917.50 | $36,845.58 | $47,237.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,824.50 / $26,728.38 / $33,806.57
| Facility | | $13,824.50 | $26,728.38 | $33,806.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,283.40 / $18,464.30 / $29,525.20
| Facility | | $12,283.40 | $18,464.30 | $29,525.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,365.27 / $24,564.78 / $37,321.04
| Facility | | $14,365.27 | $24,564.78 | $37,321.04 |