- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,304.45 / $15,211.80 / $21,538.20
| Facility | | $8,304.45 | $15,211.80 | $21,538.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,333.09 / $22,333.09 / $22,333.09
| Facility | | $22,333.09 | $22,333.09 | $22,333.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,088.93 / $14,581.89 / $22,905.21
| Facility | | $9,088.93 | $14,581.89 | $22,905.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,634.12 / $13,683.77 / $24,345.60
| Facility | | $8,634.12 | $13,683.77 | $24,345.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,494.44 / $12,485.53 / $28,788.72
| Facility | | $5,494.44 | $12,485.53 | $28,788.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $12,629.36 / $25,583.16
| Facility | | $3,308.00 | $12,629.36 | $25,583.16 |