- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,082.50 / $24,919.50 / $30,089.80
| Facility | | $13,082.50 | $24,919.50 | $30,089.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $22,501.90 / $34,950.10
| Facility | | $6,916.00 | $22,501.90 | $34,950.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,559.20 / $20,858.50 / $24,758.22
| Facility | | $15,559.20 | $20,858.50 | $24,758.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,775.45 / $16,348.90 / $21,157.40
| Facility | | $10,775.45 | $16,348.90 | $21,157.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,996.21 / $20,664.88 / $31,293.34
| Facility | | $11,996.21 | $20,664.88 | $31,293.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,253.82 / $18,610.55 / $23,251.26
| Facility | | $13,253.82 | $18,610.55 | $23,251.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,357.86 / $23,463.73 / $28,362.86
| Facility | | $17,357.86 | $23,463.73 | $28,362.86 |