- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,642.20 / $24,993.70 / $40,625.30
| Facility | | $14,642.20 | $24,993.70 | $40,625.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,321.47 / $25,321.47 / $25,321.47
| Facility | | $25,321.47 | $25,321.47 | $25,321.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,508.86 / $19,858.75 / $31,329.10
| Facility | | $12,508.86 | $19,858.75 | $31,329.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,396.13 / $25,567.55 / $47,780.28
| Facility | | $12,396.13 | $25,567.55 | $47,780.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,637.44 / $22,598.92 / $30,084.33
| Facility | | $14,637.44 | $22,598.92 | $30,084.33 |