- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,683.70 / $28,478.50 / $46,289.50
| Facility | | $16,683.70 | $28,478.50 | $46,289.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,494.16 / $24,494.16 / $24,494.16
| Facility | | $24,494.16 | $24,494.16 | $24,494.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,306.21 / $22,627.58 / $35,697.19
| Facility | | $14,306.21 | $22,627.58 | $35,697.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,191.23 / $23,984.84 / $44,726.64
| Facility | | $13,191.23 | $23,984.84 | $44,726.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,678.28 / $25,749.81 / $34,278.87
| Facility | | $16,678.28 | $25,749.81 | $34,278.87 |