- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,438.40 / $24,374.40 / $42,891.90
| Facility | | $14,438.40 | $24,374.40 | $42,891.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,713.41 / $22,377.56 / $36,911.39
| Facility | | $15,713.41 | $22,377.56 | $36,911.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,133.98 / $22,094.74 / $30,620.09
| Facility | | $13,133.98 | $22,094.74 | $30,620.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,576.40 / $46,576.40 / $54,661.36
| Facility | | $46,576.40 | $46,576.40 | $54,661.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,520.00 / $22,399.63 / $30,179.46
| Facility | | $2,520.00 | $22,399.63 | $30,179.46 |