- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,520.60 / $21,768.90 / $35,050.60
| Facility | | $9,520.60 | $21,768.90 | $35,050.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $9,030.75 / $32,324.50
| Facility | | $1,474.01 | $9,030.75 | $32,324.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,757.86 / $22,760.75 / $32,745.00
| Facility | | $15,757.86 | $22,760.75 | $32,745.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,774.10 / $19,090.07 / $40,091.50
| Facility | | $13,774.10 | $19,090.07 | $40,091.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,932.45 / $19,090.07 / $40,609.16
| Facility | | $12,932.45 | $19,090.07 | $40,609.16 |