- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,758.50 / $24,914.70 / $43,842.70
| Facility | | $14,758.50 | $24,914.70 | $43,842.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,988.93 / $22,338.17 / $35,229.71
| Facility | | $12,988.93 | $22,338.17 | $35,229.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,076.96 / $21,120.27 / $34,456.68
| Facility | | $14,076.96 | $21,120.27 | $34,456.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,425.13 / $22,584.54 / $31,190.57
| Facility | | $13,425.13 | $22,584.54 | $31,190.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,316.70 / $46,316.70 / $54,356.58
| Facility | | $46,316.70 | $46,316.70 | $54,356.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,158.00 / $22,896.19 / $36,375.21
| Facility | | $3,158.00 | $22,896.19 | $36,375.21 |