- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,962.30 / $26,478.80 / $35,532.50
| Facility | | $15,962.30 | $26,478.80 | $35,532.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,610.22 / $18,610.22 / $18,610.22
| Facility | | $18,610.22 | $18,610.22 | $18,610.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,097.91 / $22,940.08 / $36,705.01
| Facility | | $13,097.91 | $22,940.08 | $36,705.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,107.23 / $21,319.50 / $48,894.14
| Facility | | $13,107.23 | $21,319.50 | $48,894.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,561.81 / $21,001.13 / $29,750.65
| Facility | | $15,561.81 | $21,001.13 | $29,750.65 |