- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,076.90 / $23,953.70 / $33,915.80
| Facility | | $13,076.90 | $23,953.70 | $33,915.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,880.01 / $25,880.01 / $28,823.44
| Facility | | $25,880.01 | $25,880.01 | $28,823.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,659.25 / $20,286.12 / $32,100.51
| Facility | | $12,659.25 | $20,286.12 | $32,100.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,596.00 / $21,547.60 / $38,336.60
| Facility | | $13,596.00 | $21,547.60 | $38,336.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $20,747.03 / $45,333.10
| Facility | | $7,117.00 | $20,747.03 | $45,333.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $19,887.24 / $40,285.36
| Facility | | $3,308.00 | $19,887.24 | $40,285.36 |