- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,249.30 / $14,901.30 / $26,071.60
| Facility | | $11,249.30 | $14,901.30 | $26,071.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,056.49 / $29,056.49 / $29,056.49
| Facility | | $29,056.49 | $29,056.49 | $29,056.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,482.97 / $12,449.35 / $24,808.62
| Facility | | $5,482.97 | $12,449.35 | $24,808.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,361.08 / $15,134.53 / $23,277.38
| Facility | | $10,361.08 | $15,134.53 | $23,277.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $15,356.48 / $23,455.13
| Facility | | $3,496.00 | $15,356.48 | $23,455.13 |