- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,660.45 / $21,107.20 / $35,042.90
| Facility | | $13,660.45 | $21,107.20 | $35,042.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,561.40 / $7,561.40 / $7,561.40
| Facility | | $7,561.40 | $7,561.40 | $7,561.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,646.27 / $18,944.86 / $32,092.99
| Facility | | $12,646.27 | $18,944.86 | $32,092.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,193.72 / $22,513.23 / $32,371.28
| Facility | | $18,193.72 | $22,513.23 | $32,371.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,310.00 / $22,601.90 / $56,549.13
| Facility | | $11,310.00 | $22,601.90 | $56,549.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,877.51 / $22,120.55 / $30,328.90
| Facility | | $10,877.51 | $22,120.55 | $30,328.90 |