- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,561.30 / $19,288.50 / $33,747.50
| Facility | | $14,561.30 | $19,288.50 | $33,747.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,896.63 / $24,896.63 / $24,896.63
| Facility | | $24,896.63 | $24,896.63 | $24,896.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $16,431.38 / $32,490.97
| Facility | | $5,939.30 | $16,431.38 | $32,490.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,649.00 / $18,505.70 / $30,130.65
| Facility | | $12,649.00 | $18,505.70 | $30,130.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $19,877.71 / $30,360.74
| Facility | | $3,496.00 | $19,877.71 | $30,360.74 |