- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,392.60 / $20,920.80 / $36,814.50
| Facility | | $12,392.60 | $20,920.80 | $36,814.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,667.95 / $7,906.41 / $13,079.37
| Facility | | $5,667.95 | $7,906.41 | $13,079.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,273.01 / $19,154.28 / $26,627.50
| Facility | | $11,273.01 | $19,154.28 | $26,627.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,939.10 / $38,939.10 / $45,698.34
| Facility | | $38,939.10 | $38,939.10 | $45,698.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $17,863.00 / $26,042.69
| Facility | | $1,787.00 | $17,863.00 | $26,042.69 |