- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,577.30 / $21,232.50 / $37,363.10
| Facility | | $12,577.30 | $21,232.50 | $37,363.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,762.36 / $12,934.10 / $21,447.94
| Facility | | $8,762.36 | $12,934.10 | $21,447.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,441.01 / $19,413.05 / $27,024.34
| Facility | | $11,441.01 | $19,413.05 | $27,024.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,756.25 / $38,756.25 / $45,483.75
| Facility | | $38,756.25 | $38,756.25 | $45,483.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $18,503.98 / $26,430.81
| Facility | | $1,787.00 | $18,503.98 | $26,430.81 |