- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,722.32 / $25,723.30 / $41,179.10
| Facility | | $16,722.32 | $25,723.30 | $41,179.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,600.21 / $27,600.21 / $27,600.21
| Facility | | $27,600.21 | $27,600.21 | $27,600.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,493.46 / $20,084.12 / $28,968.71
| Facility | | $10,493.46 | $20,084.12 | $28,968.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,317.00 / $20,520.27 / $35,954.25
| Facility | | $15,317.00 | $20,520.27 | $35,954.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,040.05 / $23,239.41 / $31,141.50
| Facility | | $15,040.05 | $23,239.41 | $31,141.50 |