- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,491.50 / $18,616.09 / $31,156.70
| Facility | | $13,491.50 | $18,616.09 | $31,156.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,263.10 / $33,263.10 / $33,263.10
| Facility | | $33,263.10 | $33,263.10 | $33,263.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,272.00 / $21,376.22 / $33,088.78
| Facility | | $3,272.00 | $21,376.22 | $33,088.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,808.39 / $20,943.87 / $35,122.74
| Facility | | $13,808.39 | $20,943.87 | $35,122.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,062.00 / $21,357.18 / $37,585.47
| Facility | | $4,062.00 | $21,357.18 | $37,585.47 |