- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,140.20 / $21,379.90 / $37,406.69
| Facility | | $16,140.20 | $21,379.90 | $37,406.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,640.27 / $18,640.27 / $18,640.27
| Facility | | $18,640.27 | $18,640.27 | $18,640.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $17,468.68 / $33,458.74
| Facility | | $5,939.30 | $17,468.68 | $33,458.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,591.78 / $21,189.00 / $33,397.65
| Facility | | $13,591.78 | $21,189.00 | $33,397.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $22,033.00 / $37,846.62
| Facility | | $3,496.00 | $22,033.00 | $37,846.62 |