- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,636.10 / $23,276.30 / $37,833.80
| Facility | | $13,636.10 | $23,276.30 | $37,833.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,758.02 / $21,758.02 / $25,317.29
| Facility | | $21,758.02 | $21,758.02 | $25,317.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,692.90 / $18,494.21 / $29,176.40
| Facility | | $11,692.90 | $18,494.21 | $29,176.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,677.72 / $19,101.43 / $35,568.96
| Facility | | $10,677.72 | $19,101.43 | $35,568.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,008.68 / $21,491.70 / $27,730.00
| Facility | | $15,008.68 | $21,491.70 | $27,730.00 |