- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,227.70 / $16,197.30 / $28,339.20
| Facility | | $12,227.70 | $16,197.30 | $28,339.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,898.39 / $14,898.39 / $14,898.39
| Facility | | $14,898.39 | $14,898.39 | $14,898.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $13,633.45 / $27,717.36
| Facility | | $5,939.30 | $13,633.45 | $27,717.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,456.03 / $16,450.84 / $25,301.93
| Facility | | $11,456.03 | $16,450.84 | $25,301.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $16,692.11 / $28,672.45
| Facility | | $3,496.00 | $16,692.11 | $28,672.45 |