- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,139.10 / $25,469.60 / $41,009.30
| Facility | | $11,139.10 | $25,469.60 | $41,009.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,791.97 / $22,791.97 / $22,791.97
| Facility | | $22,791.97 | $22,791.97 | $22,791.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $15,343.47 / $35,841.67
| Facility | | $1,474.01 | $15,343.47 | $35,841.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,169.36 / $25,223.92 / $37,724.71
| Facility | | $17,169.36 | $25,223.92 | $37,724.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,115.70 / $27,250.56 / $46,907.06
| Facility | | $16,115.70 | $27,250.56 | $46,907.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,115.70 / $27,250.56 / $43,819.00
| Facility | | $16,115.70 | $27,250.56 | $43,819.00 |