- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,134.40 / $26,863.10 / $41,961.90
| Facility | | $16,134.40 | $26,863.10 | $41,961.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,296.63 / $19,296.63 / $26,864.55
| Facility | | $19,296.63 | $19,296.63 | $26,864.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,393.52 / $24,665.93 / $37,369.42
| Facility | | $15,393.52 | $24,665.93 | $37,369.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,516.00 / $21,258.22 / $35,438.15
| Facility | | $7,516.00 | $21,258.22 | $35,438.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,516.00 / $20,994.40 / $32,306.39
| Facility | | $7,516.00 | $20,994.40 | $32,306.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,174.21 / $27,356.61 / $39,081.39
| Facility | | $8,174.21 | $27,356.61 | $39,081.39 |