- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,733.30 / $24,814.90 / $43,416.60
| Facility | | $18,733.30 | $24,814.90 | $43,416.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,258.36 / $14,258.36 / $14,258.36
| Facility | | $14,258.36 | $14,258.36 | $14,258.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $21,451.50 / $42,957.02
| Facility | | $5,939.30 | $21,451.50 | $42,957.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,259.61 / $25,424.12 / $38,763.44
| Facility | | $17,259.61 | $25,424.12 | $38,763.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $31,010.76 / $45,033.00
| Facility | | $3,496.00 | $31,010.76 | $45,033.00 |