- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,536.20 / $16,157.50 / $32,836.19
| Facility | | $12,536.20 | $16,157.50 | $32,836.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,538.79 / $14,538.79 / $14,538.79
| Facility | | $14,538.79 | $14,538.79 | $14,538.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,388.79 / $15,529.61 / $17,754.36
| Facility | | $12,388.79 | $15,529.61 | $17,754.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,006.57 / $17,712.68 / $23,036.10
| Facility | | $10,006.57 | $17,712.68 | $23,036.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,719.61 / $16,719.61 / $21,595.49
| Facility | | $16,719.61 | $16,719.61 | $21,595.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $14,205.13 / $21,876.25
| Facility | | $1,286.00 | $14,205.13 | $21,876.25 |