- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,778.20 / $23,040.90 / $30,283.60
| Facility | | $15,778.20 | $23,040.90 | $30,283.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,715.73 / $23,715.73 / $23,715.73
| Facility | | $23,715.73 | $23,715.73 | $23,715.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,672.68 / $12,725.46 / $21,523.40
| Facility | | $4,672.68 | $12,725.46 | $21,523.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,028.49 / $23,143.26 / $38,736.58
| Facility | | $16,028.49 | $23,143.26 | $38,736.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,846.83 / $25,828.18 / $37,711.25
| Facility | | $19,846.83 | $25,828.18 | $37,711.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,846.83 / $24,010.74 / $37,711.25
| Facility | | $19,846.83 | $24,010.74 | $37,711.25 |