- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,327.20 / $34,697.80 / $56,398.40
| Facility | | $20,327.20 | $34,697.80 | $56,398.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,258.00 / $31,504.77 / $42,350.50
| Facility | | $11,258.00 | $31,504.77 | $42,350.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,365.53 / $27,569.09 / $43,492.90
| Facility | | $17,365.53 | $27,569.09 | $43,492.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,365.75 / $22,443.17 / $43,864.15
| Facility | | $10,365.75 | $22,443.17 | $43,864.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,842.00 / $28,794.38 / $39,607.26
| Facility | | $6,842.00 | $28,794.38 | $39,607.26 |