- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,427.30 / $22,389.90 / $37,254.50
| Facility | | $13,427.30 | $22,389.90 | $37,254.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,904.72 / $20,904.72 / $20,904.72
| Facility | | $20,904.72 | $20,904.72 | $20,904.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,513.86 / $18,211.03 / $28,729.66
| Facility | | $11,513.86 | $18,211.03 | $28,729.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,762.36 / $15,422.19 / $31,920.69
| Facility | | $6,762.36 | $15,422.19 | $31,920.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,422.94 / $20,723.84 / $27,588.17
| Facility | | $13,422.94 | $20,723.84 | $27,588.17 |