- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,009.20 / $19,344.80 / $39,313.80
| Facility | | $15,009.20 | $19,344.80 | $39,313.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,600.64 / $20,867.86 / $23,438.13
| Facility | | $20,600.64 | $20,867.86 | $23,438.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,731.79 / $18,466.61 / $21,112.11
| Facility | | $14,731.79 | $18,466.61 | $21,112.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,980.54 / $21,206.81 / $27,580.38
| Facility | | $11,980.54 | $21,206.81 | $27,580.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,690.74 / $25,146.68 / $27,033.78
| Facility | | $23,690.74 | $25,146.68 | $27,033.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $19,374.00 / $27,090.26
| Facility | | $1,518.00 | $19,374.00 | $27,090.26 |