- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,121.50 / $27,215.70 / $47,891.80
| Facility | | $16,121.50 | $27,215.70 | $47,891.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,317.52 / $16,317.52 / $16,317.52
| Facility | | $16,317.52 | $16,317.52 | $16,317.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,245.34 / $15,123.13 / $25,077.89
| Facility | | $10,245.34 | $15,123.13 | $25,077.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,286.60 / $24,670.35 / $33,849.92
| Facility | | $14,286.60 | $24,670.35 | $33,849.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52,605.15 / $52,605.15 / $61,736.61
| Facility | | $52,605.15 | $52,605.15 | $61,736.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $23,718.28 / $33,878.85
| Facility | | $1,787.00 | $23,718.28 | $33,878.85 |