- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,514.59 / $21,875.80 / $38,274.40
| Facility | | $16,514.59 | $21,875.80 | $38,274.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,649.42 / $10,649.42 / $10,649.42
| Facility | | $10,649.42 | $10,649.42 | $10,649.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $17,597.66 / $34,366.69
| Facility | | $5,939.30 | $17,597.66 | $34,366.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,307.00 / $20,988.02 / $34,172.33
| Facility | | $13,307.00 | $20,988.02 | $34,172.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $22,544.07 / $32,869.19
| Facility | | $3,496.00 | $22,544.07 | $32,869.19 |