- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,621.90 / $21,288.50 / $30,142.30
| Facility | | $11,621.90 | $21,288.50 | $30,142.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,508.22 / $17,508.22 / $17,508.22
| Facility | | $17,508.22 | $17,508.22 | $17,508.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,603.29 / $20,203.08 / $31,747.19
| Facility | | $12,603.29 | $20,203.08 | $31,747.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,083.28 / $19,150.16 / $34,071.19
| Facility | | $12,083.28 | $19,150.16 | $34,071.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $18,025.68 / $40,289.24
| Facility | | $7,117.00 | $18,025.68 | $40,289.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $17,674.54 / $35,803.12
| Facility | | $3,308.00 | $17,674.54 | $35,803.12 |