- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,676.50 / $25,879.90 / $41,429.80
| Facility | | $16,676.50 | $25,879.90 | $41,429.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,024.59 / $25,024.59 / $25,024.59
| Facility | | $25,024.59 | $25,024.59 | $25,024.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,424.96 / $20,280.02 / $28,779.65
| Facility | | $10,424.96 | $20,280.02 | $28,779.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,860.36 / $20,830.00 / $36,173.08
| Facility | | $15,860.36 | $20,830.00 | $36,173.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,131.60 / $22,834.09 / $31,331.04
| Facility | | $15,131.60 | $22,834.09 | $31,331.04 |