- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,845.60 / $25,361.80 / $35,909.60
| Facility | | $13,845.60 | $25,361.80 | $35,909.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,573.91 / $25,008.77 / $40,030.81
| Facility | | $15,573.91 | $25,008.77 | $40,030.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,395.26 / $22,814.31 / $40,590.26
| Facility | | $14,395.26 | $22,814.31 | $40,590.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $21,525.28 / $47,998.07
| Facility | | $7,117.00 | $21,525.28 | $47,998.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $21,056.34 / $42,653.59
| Facility | | $3,308.00 | $21,056.34 | $42,653.59 |