- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,755.20 / $21,518.00 / $34,930.50
| Facility | | $14,755.20 | $21,518.00 | $34,930.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,478.87 / $26,478.87 / $26,478.87
| Facility | | $26,478.87 | $26,478.87 | $26,478.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,387.15 / $40,356.57 / $51,739.19
| Facility | | $28,387.15 | $40,356.57 | $51,739.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,326.07 / $33,944.62 / $45,619.54
| Facility | | $17,326.07 | $33,944.62 | $45,619.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,394.60 / $23,141.10 / $37,003.60
| Facility | | $15,394.60 | $23,141.10 | $37,003.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,003.80 / $30,786.72 / $46,773.98
| Facility | | $18,003.80 | $30,786.72 | $46,773.98 |