- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,526.90 / $16,145.50 / $32,811.80
| Facility | | $12,526.90 | $16,145.50 | $32,811.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,697.55 / $18,697.55 / $18,832.00
| Facility | | $18,697.55 | $18,697.55 | $18,832.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,323.47 / $15,447.73 / $17,660.75
| Facility | | $12,323.47 | $15,447.73 | $17,660.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,999.12 / $17,699.50 / $23,018.98
| Facility | | $9,999.12 | $17,699.50 | $23,018.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,502.18 / $21,502.18 / $21,656.81
| Facility | | $21,502.18 | $21,502.18 | $21,656.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $16,082.52 / $22,609.93
| Facility | | $1,518.00 | $16,082.52 | $22,609.93 |