- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,507.10 / $19,724.30 / $25,924.50
| Facility | | $13,507.10 | $19,724.30 | $25,924.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,118.40 / $15,118.40 / $15,118.40
| Facility | | $15,118.40 | $15,118.40 | $15,118.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,765.58 / $18,575.23 / $31,163.77
| Facility | | $6,765.58 | $18,575.23 | $31,163.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,721.32 / $19,811.97 / $35,501.82
| Facility | | $13,721.32 | $19,811.97 | $35,501.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,990.03 / $22,110.42 / $32,283.01
| Facility | | $16,990.03 | $22,110.42 | $32,283.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,990.03 / $20,554.58 / $32,283.01
| Facility | | $16,990.03 | $20,554.58 | $32,283.01 |