- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,013.00 / $15,196.20 / $25,433.10
| Facility | | $11,013.00 | $15,196.20 | $25,433.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,419.52 / $23,419.52 / $30,676.36
| Facility | | $23,419.52 | $23,419.52 | $30,676.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,272.00 / $17,372.62 / $27,105.49
| Facility | | $3,272.00 | $17,372.62 | $27,105.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,271.75 / $17,096.41 / $28,670.59
| Facility | | $11,271.75 | $17,096.41 | $28,670.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,062.00 / $17,433.80 / $30,680.90
| Facility | | $4,062.00 | $17,433.80 | $30,680.90 |