- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,156.40 / $22,210.20 / $39,083.60
| Facility | | $13,156.40 | $22,210.20 | $39,083.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,037.89 / $14,695.91 / $24,133.76
| Facility | | $10,037.89 | $14,695.91 | $24,133.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,967.83 / $20,224.48 / $28,268.71
| Facility | | $11,967.83 | $20,224.48 | $28,268.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,898.40 / $39,898.40 / $46,824.16
| Facility | | $39,898.40 | $39,898.40 | $46,824.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $19,356.02 / $27,647.86
| Facility | | $1,787.00 | $19,356.02 | $27,647.86 |