- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,029.70 / $24,868.40 / $32,685.70
| Facility | | $17,029.70 | $24,868.40 | $32,685.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,110.77 / $14,031.87 / $23,541.35
| Facility | | $5,110.77 | $14,031.87 | $23,541.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,924.56 / $25,094.08 / $44,760.75
| Facility | | $17,924.56 | $25,094.08 | $44,760.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,421.06 / $27,876.85 / $40,702.48
| Facility | | $21,421.06 | $27,876.85 | $40,702.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,421.06 / $25,915.25 / $40,702.48
| Facility | | $21,421.06 | $25,915.25 | $40,702.48 |