- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,768.20 / $15,703.60 / $25,491.90
| Facility | | $10,768.20 | $15,703.60 | $25,491.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,820.97 / $25,820.97 / $25,820.97
| Facility | | $25,820.97 | $25,820.97 | $25,820.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,573.05 / $46,307.45 / $59,368.52
| Facility | | $32,573.05 | $46,307.45 | $59,368.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,644.40 / $24,446.76 / $30,920.72
| Facility | | $12,644.40 | $24,446.76 | $30,920.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,234.80 / $16,888.09 / $27,004.90
| Facility | | $11,234.80 | $16,888.09 | $27,004.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,139.00 / $22,467.85 / $34,135.19
| Facility | | $13,139.00 | $22,467.85 | $34,135.19 |