- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,140.66 / $21,888.10 / $35,039.60
| Facility | | $14,140.66 | $21,888.10 | $35,039.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,929.05 / $14,929.05 / $14,929.05
| Facility | | $14,929.05 | $14,929.05 | $14,929.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,583.32 / $16,697.40 / $23,695.52
| Facility | | $8,583.32 | $16,697.40 | $23,695.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,033.35 / $17,460.84 / $30,593.74
| Facility | | $13,033.35 | $17,460.84 | $30,593.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,797.69 / $20,065.00 / $27,078.91
| Facility | | $12,797.69 | $20,065.00 | $27,078.91 |