- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,264.30 / $25,755.80 / $41,470.10
| Facility | | $11,264.30 | $25,755.80 | $41,470.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,619.28 / $23,619.28 / $23,619.28
| Facility | | $23,619.28 | $23,619.28 | $23,619.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $13,424.63 / $36,240.44
| Facility | | $1,474.01 | $13,424.63 | $36,240.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,643.90 / $26,929.36 / $38,148.68
| Facility | | $18,643.90 | $26,929.36 | $38,148.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,301.02 / $22,036.04 / $46,648.29
| Facility | | $15,301.02 | $22,036.04 | $46,648.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,301.02 / $22,586.40 / $48,046.69
| Facility | | $15,301.02 | $22,586.40 | $48,046.69 |