- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,217.30 / $22,561.50 / $36,671.90
| Facility | | $13,217.30 | $22,561.50 | $36,671.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,206.60 / $29,206.60 / $29,206.60
| Facility | | $29,206.60 | $29,206.60 | $29,206.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,333.78 / $17,926.20 / $28,280.31
| Facility | | $11,333.78 | $17,926.20 | $28,280.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,399.48 / $14,596.43 / $28,554.19
| Facility | | $7,399.48 | $14,596.43 | $28,554.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,316.39 / $18,757.00 / $25,753.76
| Facility | | $6,316.39 | $18,757.00 | $25,753.76 |