- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,372.80 / $29,990.90 / $42,463.90
| Facility | | $16,372.80 | $29,990.90 | $42,463.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,994.21 / $27,283.29 / $42,913.05
| Facility | | $16,994.21 | $27,283.29 | $42,913.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,022.72 / $26,978.43 / $47,998.91
| Facility | | $17,022.72 | $26,978.43 | $47,998.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $25,374.52 / $56,758.80
| Facility | | $7,117.00 | $25,374.52 | $56,758.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $24,899.60 / $50,438.84
| Facility | | $3,308.00 | $24,899.60 | $50,438.84 |