- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $20,892.96 / $36,307.81
| Facility | | $16,595.87 | $20,892.96 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $19,952.62 / $19,952.62
| Facility | | $19,952.62 | $19,952.62 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $20,417.38 / $31,622.78
| Facility | | $12,022.64 | $20,417.38 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $28,183.83 / $36,307.81
| Facility | | $17,378.01 | $28,183.83 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $25,703.96 / $39,810.72
| Facility | | $15,488.17 | $25,703.96 | $39,810.72 |