- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,950.60 / $16,093.60 / $24,847.10
| Facility | | $10,950.60 | $16,093.60 | $24,847.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,500.47 / $22,500.47 / $22,500.47
| Facility | | $22,500.47 | $22,500.47 | $22,500.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,557.27 / $26,381.92 / $33,822.98
| Facility | | $18,557.27 | $26,381.92 | $33,822.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,324.54 / $23,828.33 / $30,138.53
| Facility | | $12,324.54 | $23,828.33 | $30,138.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,950.60 / $16,460.90 / $26,321.70
| Facility | | $10,950.60 | $16,460.90 | $26,321.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,806.63 / $21,899.49 / $33,271.69
| Facility | | $12,806.63 | $21,899.49 | $33,271.69 |