- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,782.60 / $21,819.50 / $35,465.80
| Facility | | $12,782.60 | $21,819.50 | $35,465.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,668.71 / $19,668.71 / $19,668.71
| Facility | | $19,668.71 | $19,668.71 | $19,668.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,027.00 / $17,336.66 / $27,350.26
| Facility | | $11,027.00 | $17,336.66 | $27,350.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,875.62 / $15,788.30 / $28,966.68
| Facility | | $8,875.62 | $15,788.30 | $28,966.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,702.26 / $19,728.83 / $26,263.58
| Facility | | $13,702.26 | $19,728.83 | $26,263.58 |