- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,838.80 / $24,782.80 / $39,903.50
| Facility | | $10,838.80 | $24,782.80 | $39,903.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,174.58 / $22,174.58 / $22,174.58
| Facility | | $22,174.58 | $22,174.58 | $22,174.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $13,141.77 / $33,493.18
| Facility | | $1,474.01 | $13,141.77 | $33,493.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,939.58 / $25,912.05 / $36,707.53
| Facility | | $17,939.58 | $25,912.05 | $36,707.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,681.17 / $21,733.15 / $45,642.29
| Facility | | $15,681.17 | $21,733.15 | $45,642.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,722.99 / $21,733.15 / $46,231.62
| Facility | | $14,722.99 | $21,733.15 | $46,231.62 |