- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,664.30 / $21,414.20 / $30,997.80
| Facility | | $14,664.30 | $21,414.20 | $30,997.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,012.86 / $25,012.86 / $25,012.86
| Facility | | $25,012.86 | $25,012.86 | $25,012.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,873.52 / $29,853.78 / $50,085.87
| Facility | | $10,873.52 | $29,853.78 | $50,085.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,434.81 / $21,608.47 / $38,543.42
| Facility | | $15,434.81 | $21,608.47 | $38,543.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,445.65 / $24,004.72 / $35,048.83
| Facility | | $18,445.65 | $24,004.72 | $35,048.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,445.65 / $22,315.58 / $35,048.83
| Facility | | $18,445.65 | $22,315.58 | $35,048.83 |