- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,808.20 / $17,146.20 / $28,437.50
| Facility | | $10,808.20 | $17,146.20 | $28,437.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,489.41 / $16,489.41 / $16,489.41
| Facility | | $16,489.41 | $16,489.41 | $16,489.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,550.03 / $15,633.17 / $26,773.28
| Facility | | $10,550.03 | $15,633.17 | $26,773.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,764.30 / $18,269.61 / $26,269.47
| Facility | | $14,764.30 | $18,269.61 | $26,269.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,178.12 / $18,341.57 / $47,175.59
| Facility | | $9,178.12 | $18,341.57 | $47,175.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,178.12 / $17,511.86 / $24,612.06
| Facility | | $9,178.12 | $17,511.86 | $24,612.06 |