- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $24,547.09 / $26,915.35
| Facility | | $9,549.93 | $24,547.09 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,442.29 / $23,442.29 / $23,442.29
| Facility | | $23,442.29 | $23,442.29 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $27,542.29 / $46,773.51
| Facility | | $16,982.44 | $27,542.29 | $46,773.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $27,542.29 / $46,773.51
| Facility | | $16,218.10 | $27,542.29 | $46,773.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $19,498.45 / $43,651.58
| Facility | | $14,125.38 | $19,498.45 | $43,651.58 |