- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,460.80 / $20,889.50 / $33,441.00
| Facility | | $13,460.80 | $20,889.50 | $33,441.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,162.81 / $19,162.81 / $19,162.81
| Facility | | $19,162.81 | $19,162.81 | $19,162.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,571.34 / $16,674.09 / $23,662.43
| Facility | | $8,571.34 | $16,674.09 | $23,662.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,438.71 / $16,664.21 / $29,197.92
| Facility | | $12,438.71 | $16,664.21 | $29,197.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,213.81 / $18,872.38 / $25,289.56
| Facility | | $12,213.81 | $18,872.38 | $25,289.56 |