- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,245.80 / $19,737.09 / $31,596.20
| Facility | | $13,245.80 | $19,737.09 | $31,596.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,692.30 / $11,692.30 / $11,692.30
| Facility | | $11,692.30 | $11,692.30 | $11,692.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,178.13 / $15,909.16 / $22,576.91
| Facility | | $8,178.13 | $15,909.16 | $22,576.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,752.52 / $15,744.92 / $27,587.20
| Facility | | $11,752.52 | $15,744.92 | $27,587.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,540.03 / $17,831.28 / $23,894.45
| Facility | | $11,540.03 | $17,831.28 | $23,894.45 |