- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,869.70 / $28,381.40 / $47,956.30
| Facility | | $16,869.70 | $28,381.40 | $47,956.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,483.75 / $10,483.75 / $10,483.75
| Facility | | $10,483.75 | $10,483.75 | $10,483.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,753.04 / $25,899.82 / $63,260.33
| Facility | | $17,753.04 | $25,899.82 | $63,260.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,358.95 / $17,257.58 / $37,298.23
| Facility | | $8,358.95 | $17,257.58 | $37,298.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,816.11 / $24,484.22 / $33,678.54
| Facility | | $6,816.11 | $24,484.22 | $33,678.54 |