- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,139.30 / $18,838.59 / $30,157.80
| Facility | | $12,139.30 | $18,838.59 | $30,157.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,559.52 / $22,559.52 / $22,559.52
| Facility | | $22,559.52 | $22,559.52 | $22,559.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,578.89 / $14,743.45 / $20,922.64
| Facility | | $7,578.89 | $14,743.45 | $20,922.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,217.52 / $15,028.17 / $26,331.35
| Facility | | $11,217.52 | $15,028.17 | $26,331.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,014.69 / $17,019.55 / $22,806.71
| Facility | | $11,014.69 | $17,019.55 | $22,806.71 |