- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,970.20 / $18,519.59 / $32,589.10
| Facility | | $10,970.20 | $18,519.59 | $32,589.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,338.81 / $17,338.81 / $17,338.81
| Facility | | $17,338.81 | $17,338.81 | $17,338.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,335.09 / $13,812.60 / $22,628.84
| Facility | | $9,335.09 | $13,812.60 | $22,628.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,979.15 / $17,070.52 / $23,571.33
| Facility | | $9,979.15 | $17,070.52 | $23,571.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,609.94 / $33,609.94 / $39,444.12
| Facility | | $33,609.94 | $33,609.94 | $39,444.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $16,139.65 / $23,053.64
| Facility | | $1,787.00 | $16,139.65 | $23,053.64 |