- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,334.10 / $18,474.80 / $37,545.60
| Facility | | $14,334.10 | $18,474.80 | $37,545.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,185.85 / $24,185.85 / $24,185.85
| Facility | | $24,185.85 | $24,185.85 | $24,185.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,929.49 / $17,460.91 / $19,962.33
| Facility | | $13,929.49 | $17,460.91 | $19,962.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,441.72 / $20,253.04 / $26,339.95
| Facility | | $11,441.72 | $20,253.04 | $26,339.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,813.73 / $27,813.73 / $27,813.73
| Facility | | $27,813.73 | $27,813.73 | $27,813.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $18,402.75 / $25,871.88
| Facility | | $1,518.00 | $18,402.75 | $25,871.88 |