- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,456.30 / $20,262.09 / $27,844.70
| Facility | | $12,456.30 | $20,262.09 | $27,844.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,619.43 / $20,619.43 / $20,619.43
| Facility | | $20,619.43 | $20,619.43 | $20,619.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,100.33 / $19,170.12 / $29,043.14
| Facility | | $12,100.33 | $19,170.12 | $29,043.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,516.00 / $16,835.30 / $28,064.99
| Facility | | $7,516.00 | $16,835.30 | $28,064.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,516.00 / $16,626.37 / $25,584.82
| Facility | | $7,516.00 | $16,626.37 | $25,584.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,401.90 / $22,013.09 / $30,950.23
| Facility | | $9,401.90 | $22,013.09 | $30,950.23 |