- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,068.60 / $16,843.70 / $34,230.80
| Facility | | $13,068.60 | $16,843.70 | $34,230.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,000.56 / $18,441.08 / $20,963.03
| Facility | | $18,000.56 | $18,441.08 | $20,963.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,078.20 / $16,393.80 / $18,742.34
| Facility | | $13,078.20 | $16,393.80 | $18,742.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,431.56 / $18,464.96 / $24,014.48
| Facility | | $10,431.56 | $18,464.96 | $24,014.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,003.58 / $23,284.49 / $25,155.64
| Facility | | $21,003.58 | $23,284.49 | $25,155.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $16,021.20 / $22,805.37
| Facility | | $1,286.00 | $16,021.20 | $22,805.37 |