- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,933.90 / $20,894.40 / $28,912.40
| Facility | | $12,933.90 | $20,894.40 | $28,912.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,303.81 / $16,303.81 / $16,303.81
| Facility | | $16,303.81 | $16,303.81 | $16,303.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,500.39 / $16,829.25 / $25,490.83
| Facility | | $10,500.39 | $16,829.25 | $25,490.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,480.12 / $19,319.70 / $29,926.27
| Facility | | $12,480.12 | $19,319.70 | $29,926.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,358.49 / $18,567.04 / $28,320.60
| Facility | | $11,358.49 | $18,567.04 | $28,320.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,762.42 / $22,495.62 / $32,137.02
| Facility | | $9,762.42 | $22,495.62 | $32,137.02 |