- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,960.80 / $25,061.90 / $40,352.80
| Facility | | $10,960.80 | $25,061.90 | $40,352.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,064.34 / $20,064.34 / $20,064.34
| Facility | | $20,064.34 | $20,064.34 | $20,064.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $13,611.09 / $36,023.24
| Facility | | $1,474.01 | $13,611.09 | $36,023.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,141.56 / $26,203.79 / $37,120.81
| Facility | | $18,141.56 | $26,203.79 | $37,120.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,857.72 / $21,977.84 / $46,156.17
| Facility | | $15,857.72 | $21,977.84 | $46,156.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,888.75 / $21,977.84 / $46,752.14
| Facility | | $14,888.75 | $21,977.84 | $46,752.14 |