- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,119.50 / $16,909.30 / $34,364.10
| Facility | | $13,119.50 | $16,909.30 | $34,364.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,448.43 / $17,448.43 / $17,448.43
| Facility | | $17,448.43 | $17,448.43 | $17,448.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,955.37 / $16,239.83 / $18,566.32
| Facility | | $12,955.37 | $16,239.83 | $18,566.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,472.18 / $18,536.84 / $24,107.97
| Facility | | $10,472.18 | $18,536.84 | $24,107.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $14,866.10 / $22,894.15
| Facility | | $1,286.00 | $14,866.10 | $22,894.15 |