- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,361.30 / $22,164.10 / $29,742.50
| Facility | | $13,361.30 | $22,164.10 | $29,742.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,630.66 / $17,630.66 / $17,630.66
| Facility | | $17,630.66 | $17,630.66 | $17,630.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,980.75 / $16,847.50 / $26,956.65
| Facility | | $9,980.75 | $16,847.50 | $26,956.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,971.41 / $17,845.50 / $40,926.87
| Facility | | $10,971.41 | $17,845.50 | $40,926.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,948.69 / $17,579.00 / $24,902.80
| Facility | | $12,948.69 | $17,579.00 | $24,902.80 |