- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,113.80 / $16,901.90 / $34,349.10
| Facility | | $13,113.80 | $16,901.90 | $34,349.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,561.37 / $18,561.37 / $18,561.37
| Facility | | $18,561.37 | $18,561.37 | $18,561.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,093.82 / $16,413.38 / $18,764.74
| Facility | | $13,093.82 | $16,413.38 | $18,764.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,467.60 / $18,528.75 / $24,097.44
| Facility | | $10,467.60 | $18,528.75 | $24,097.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $16,836.00 / $23,669.22
| Facility | | $1,518.00 | $16,836.00 | $23,669.22 |