- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,811.90 / $20,902.09 / $20,902.09
| Facility | | $18,811.90 | $20,902.09 | $20,902.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,189.38 / $18,189.38 / $18,189.38
| Facility | | $18,189.38 | $18,189.38 | $18,189.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,600.51 / $15,982.91 / $36,372.35
| Facility | | $10,600.51 | $15,982.91 | $36,372.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,044.90 / $23,133.11 / $36,167.87
| Facility | | $13,044.90 | $23,133.11 | $36,167.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,890.13 / $31,227.17 / $40,319.50
| Facility | | $15,890.13 | $31,227.17 | $40,319.50 |