- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,890.50 / $26,767.70 / $44,440.70
| Facility | | $16,890.50 | $26,767.70 | $44,440.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,087.48 / $23,096.53 / $39,036.55
| Facility | | $15,087.48 | $23,096.53 | $39,036.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,072.92 / $29,259.98 / $51,102.83
| Facility | | $23,072.92 | $29,259.98 | $51,102.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,794.64 / $28,663.30 / $67,465.23
| Facility | | $13,794.64 | $28,663.30 | $67,465.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,794.64 / $27,366.68 / $38,462.51
| Facility | | $13,794.64 | $27,366.68 | $38,462.51 |