- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,729.74 / $15,901.50 / $26,400.30
| Facility | | $11,729.74 | $15,901.50 | $26,400.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,732.16 / $14,732.16 / $14,852.97
| Facility | | $14,732.16 | $14,732.16 | $14,852.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,529.74 / $14,276.11 / $24,184.03
| Facility | | $9,529.74 | $14,276.11 | $24,184.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,706.62 / $17,060.00 / $25,165.00
| Facility | | $13,706.62 | $17,060.00 | $25,165.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,520.62 / $16,292.80 / $42,613.22
| Facility | | $8,520.62 | $16,292.80 | $42,613.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,520.62 / $16,257.35 / $22,848.91
| Facility | | $8,520.62 | $16,257.35 | $22,848.91 |