- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,957.30 / $25,566.50 / $36,199.40
| Facility | | $13,957.30 | $25,566.50 | $36,199.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,445.91 / $26,453.32 / $42,272.17
| Facility | | $16,445.91 | $26,453.32 | $42,272.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,511.42 / $22,998.40 / $40,917.81
| Facility | | $14,511.42 | $22,998.40 | $40,917.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $22,134.28 / $48,385.38
| Facility | | $7,117.00 | $22,134.28 | $48,385.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $21,226.25 / $44,664.46
| Facility | | $3,308.00 | $21,226.25 | $44,664.46 |