- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,659.40 / $21,357.10 / $30,239.40
| Facility | | $11,659.40 | $21,357.10 | $30,239.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,517.27 / $17,517.27 / $17,517.27
| Facility | | $17,517.27 | $17,517.27 | $17,517.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,023.77 / $19,274.11 / $30,287.41
| Facility | | $12,023.77 | $19,274.11 | $30,287.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,122.22 / $19,211.88 / $34,180.99
| Facility | | $12,122.22 | $19,211.88 | $34,180.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $17,880.09 / $40,419.08
| Facility | | $7,117.00 | $17,880.09 | $40,419.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $17,731.50 / $35,918.51
| Facility | | $3,308.00 | $17,731.50 | $35,918.51 |