- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,862.93 / $16,650.30 / $29,299.60
| Facility | | $9,862.93 | $16,650.30 | $29,299.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,809.99 / $21,867.25 / $35,954.89
| Facility | | $14,809.99 | $21,867.25 | $35,954.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,971.87 / $15,347.47 / $21,192.11
| Facility | | $8,971.87 | $15,347.47 | $21,192.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,822.15 / $30,822.15 / $36,172.41
| Facility | | $30,822.15 | $30,822.15 | $36,172.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $14,510.56 / $20,726.66
| Facility | | $1,787.00 | $14,510.56 | $20,726.66 |