- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,045.20 / $20,510.09 / $29,689.20
| Facility | | $14,045.20 | $20,510.09 | $29,689.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,904.64 / $15,904.64 / $17,262.68
| Facility | | $15,904.64 | $15,904.64 | $17,262.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,896.93 / $21,506.31 / $36,375.01
| Facility | | $7,896.93 | $21,506.31 | $36,375.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,267.96 / $20,601.25 / $36,916.18
| Facility | | $14,267.96 | $20,601.25 | $36,916.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,666.90 / $22,991.28 / $33,569.14
| Facility | | $17,666.90 | $22,991.28 | $33,569.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,666.90 / $21,373.46 / $33,569.14
| Facility | | $17,666.90 | $21,373.46 | $33,569.14 |