- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,532.70 / $16,601.30 / $29,046.10
| Facility | | $12,532.70 | $16,601.30 | $29,046.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,346.03 / $13,346.03 / $13,346.03
| Facility | | $13,346.03 | $13,346.03 | $13,346.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $14,514.37 / $28,617.17
| Facility | | $5,939.30 | $14,514.37 | $28,617.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,498.56 / $16,861.20 / $25,933.05
| Facility | | $11,498.56 | $16,861.20 | $25,933.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $17,108.48 / $26,131.08
| Facility | | $3,496.00 | $17,108.48 | $26,131.08 |