- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,102.58 / $24,916.50 / $39,887.60
| Facility | | $16,102.58 | $24,916.50 | $39,887.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,677.89 / $25,677.89 / $25,677.89
| Facility | | $25,677.89 | $25,677.89 | $25,677.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,644.12 / $20,706.34 / $29,384.65
| Facility | | $10,644.12 | $20,706.34 | $29,384.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,836.59 / $19,876.66 / $34,826.55
| Facility | | $14,836.59 | $19,876.66 | $34,826.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,568.33 / $22,510.51 / $30,164.75
| Facility | | $14,568.33 | $22,510.51 | $30,164.75 |