- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,744.20 / $25,911.90 / $34,057.10
| Facility | | $17,744.20 | $25,911.90 | $34,057.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,822.45 / $20,822.45 / $20,822.45
| Facility | | $20,822.45 | $20,822.45 | $20,822.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,715.87 / $21,013.23 / $35,541.05
| Facility | | $7,715.87 | $21,013.23 | $35,541.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,025.71 / $26,027.01 / $43,563.33
| Facility | | $18,025.71 | $26,027.01 | $43,563.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,319.83 / $29,046.49 / $42,410.24
| Facility | | $22,319.83 | $29,046.49 | $42,410.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,319.83 / $27,002.58 / $42,410.24
| Facility | | $22,319.83 | $27,002.58 | $42,410.24 |