- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $22,387.21 / $41,686.94
| Facility | | $14,454.40 | $22,387.21 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $11,220.18 / $11,220.18
| Facility | | $11,220.18 | $11,220.18 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $19,054.61 / $30,199.52
| Facility | | $12,302.69 | $19,054.61 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $14,791.08 / $30,199.52
| Facility | | $6,918.31 | $14,791.08 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $19,952.62 / $28,183.83
| Facility | | $6,456.54 | $19,952.62 | $28,183.83 |