- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,025.40 / $14,620.40 / $23,733.50
| Facility | | $10,025.40 | $14,620.40 | $23,733.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,857.65 / $19,857.65 / $19,857.65
| Facility | | $19,857.65 | $19,857.65 | $19,857.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,751.09 / $30,922.41 / $39,644.12
| Facility | | $21,751.09 | $30,922.41 | $39,644.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,772.18 / $22,760.40 / $28,787.79
| Facility | | $11,772.18 | $22,760.40 | $28,787.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,459.79 / $15,723.20 / $25,142.00
| Facility | | $10,459.79 | $15,723.20 | $25,142.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,232.66 / $20,918.00 / $31,780.52
| Facility | | $12,232.66 | $20,918.00 | $31,780.52 |