- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,971.30 / $26,493.70 / $35,552.50
| Facility | | $15,971.30 | $26,493.70 | $35,552.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,699.34 / $18,699.34 / $18,699.34
| Facility | | $18,699.34 | $18,699.34 | $18,699.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,480.17 / $19,378.53 / $31,006.40
| Facility | | $11,480.17 | $19,378.53 | $31,006.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,114.61 / $21,331.50 / $48,921.66
| Facility | | $13,114.61 | $21,331.50 | $48,921.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,478.14 / $21,012.95 / $29,767.40
| Facility | | $15,478.14 | $21,012.95 | $29,767.40 |