- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,505.40 / $16,117.70 / $32,755.50
| Facility | | $12,505.40 | $16,117.70 | $32,755.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,260.73 / $12,407.26 / $18,565.28
| Facility | | $10,260.73 | $12,407.26 | $18,565.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,624.51 / $15,825.09 / $18,092.16
| Facility | | $12,624.51 | $15,825.09 | $18,092.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,599.05 / $22,599.05 / $22,599.05
| Facility | | $22,599.05 | $22,599.05 | $22,599.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,625.95 / $14,754.82 / $21,418.57
| Facility | | $3,625.95 | $14,754.82 | $21,418.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $14,170.21 / $21,822.48
| Facility | | $1,286.00 | $14,170.21 | $21,822.48 |