- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $19,952.62 / $26,302.68
| Facility | | $12,302.69 | $19,952.62 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $15,488.17 / $19,054.61
| Facility | | $10,471.29 | $15,488.17 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $23,988.33 / $23,988.33
| Facility | | $23,988.33 | $23,988.33 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $18,197.01 / $24,547.09
| Facility | | $12,589.25 | $18,197.01 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $23,988.33 / $23,988.33
| Facility | | $23,988.33 | $23,988.33 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $17,378.01 / $27,542.29
| Facility | | $10,964.78 | $17,378.01 | $27,542.29 |