- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,691.50 / $24,759.40 / $43,319.60
| Facility | | $18,691.50 | $24,759.40 | $43,319.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,585.88 / $19,901.58 / $28,465.89
| Facility | | $14,585.88 | $19,901.58 | $28,465.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $22,929.61 / $43,943.82
| Facility | | $5,939.30 | $22,929.61 | $43,943.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,095.55 / $23,754.60 / $38,676.83
| Facility | | $14,095.55 | $23,754.60 | $38,676.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $25,515.77 / $38,972.18
| Facility | | $3,496.00 | $25,515.77 | $38,972.18 |