- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,010.90 / $15,480.50 / $31,460.40
| Facility | | $12,010.90 | $15,480.50 | $31,460.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,928.52 / $4,928.52 / $4,928.52
| Facility | | $4,928.52 | $4,928.52 | $4,928.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,083.49 / $15,146.91 / $17,316.83
| Facility | | $12,083.49 | $15,146.91 | $17,316.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,587.29 / $16,970.50 / $22,070.88
| Facility | | $9,587.29 | $16,970.50 | $22,070.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $13,609.93 / $20,959.63
| Facility | | $1,286.00 | $13,609.93 | $20,959.63 |