- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,001.60 / $26,544.00 / $35,620.00
| Facility | | $16,001.60 | $26,544.00 | $35,620.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,848.19 / $43,848.19 / $43,848.19
| Facility | | $43,848.19 | $43,848.19 | $43,848.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,047.10 / $22,851.08 / $36,562.62
| Facility | | $13,047.10 | $22,851.08 | $36,562.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,139.51 / $21,372.00 / $49,014.54
| Facility | | $13,139.51 | $21,372.00 | $49,014.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,600.14 / $21,052.84 / $29,823.91
| Facility | | $15,600.14 | $21,052.84 | $29,823.91 |