- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,341.70 / $19,482.90 / $25,607.20
| Facility | | $13,341.70 | $19,482.90 | $25,607.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,460.89 / $15,460.89 / $15,460.89
| Facility | | $15,460.89 | $15,460.89 | $15,460.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,484.13 / $15,116.00 / $25,261.15
| Facility | | $5,484.13 | $15,116.00 | $25,261.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,553.38 / $19,569.49 / $32,754.90
| Facility | | $13,553.38 | $19,569.49 | $32,754.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,782.09 / $21,839.81 / $31,887.90
| Facility | | $16,782.09 | $21,839.81 | $31,887.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,782.09 / $20,303.00 / $31,887.90
| Facility | | $16,782.09 | $20,303.00 | $31,887.90 |