- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,174.90 / $27,796.70 / $39,357.19
| Facility | | $15,174.90 | $27,796.70 | $39,357.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,037.93 / $25,708.81 / $40,398.93
| Facility | | $16,037.93 | $25,708.81 | $40,398.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,777.30 / $25,004.63 / $44,487.21
| Facility | | $15,777.30 | $25,004.63 | $44,487.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $23,077.89 / $52,606.20
| Facility | | $7,117.00 | $23,077.89 | $52,606.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $23,077.89 / $47,917.00
| Facility | | $3,308.00 | $23,077.89 | $47,917.00 |