- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,236.00 / $18,968.20 / $33,378.60
| Facility | | $11,236.00 | $18,968.20 | $33,378.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,532.28 / $31,532.28 / $31,532.28
| Facility | | $31,532.28 | $31,532.28 | $31,532.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,382.31 / $13,849.21 / $22,898.89
| Facility | | $9,382.31 | $13,849.21 | $22,898.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,220.89 / $17,484.05 / $24,142.34
| Facility | | $10,220.89 | $17,484.05 | $24,142.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,965.60 / $38,965.60 / $45,729.44
| Facility | | $38,965.60 | $38,965.60 | $45,729.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,520.00 / $16,096.35 / $23,485.73
| Facility | | $2,520.00 | $16,096.35 | $23,485.73 |