- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,443.20 / $24,624.60 / $34,865.80
| Facility | | $13,443.20 | $24,624.60 | $34,865.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,075.65 / $32,075.65 / $32,075.65
| Facility | | $32,075.65 | $32,075.65 | $32,075.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,444.10 / $24,800.31 / $39,697.14
| Facility | | $15,444.10 | $24,800.31 | $39,697.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,976.82 / $22,151.14 / $39,410.40
| Facility | | $13,976.82 | $22,151.14 | $39,410.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $21,488.30 / $44,827.00
| Facility | | $7,117.00 | $21,488.30 | $44,827.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,264.00 / $20,899.58 / $41,413.74
| Facility | | $5,264.00 | $20,899.58 | $41,413.74 |