- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,011.20 / $23,381.10 / $30,730.80
| Facility | | $16,011.20 | $23,381.10 | $30,730.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,211.71 / $18,211.71 / $18,211.71
| Facility | | $18,211.71 | $18,211.71 | $18,211.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,764.32 / $15,672.53 / $26,293.89
| Facility | | $5,764.32 | $15,672.53 | $26,293.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,852.52 / $23,593.24 / $42,083.68
| Facility | | $16,852.52 | $23,593.24 | $42,083.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,139.90 / $26,209.58 / $38,268.12
| Facility | | $20,139.90 | $26,209.58 | $38,268.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,139.90 / $24,365.30 / $38,268.12
| Facility | | $20,139.90 | $24,365.30 | $38,268.12 |