- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,896.82 / $18,459.80 / $24,762.20
| Facility | | $8,896.82 | $18,459.80 | $24,762.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,311.85 / $31,311.85 / $34,097.90
| Facility | | $31,311.85 | $31,311.85 | $34,097.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,897.00 / $15,964.42 / $18,982.43
| Facility | | $3,897.00 | $15,964.42 | $18,982.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,690.83 / $19,061.75 / $30,002.61
| Facility | | $15,690.83 | $19,061.75 | $30,002.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $23,550.29 / $29,742.35
| Facility | | $1,350.00 | $23,550.29 | $29,742.35 |