- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,503.20 / $29,034.90 / $38,962.50
| Facility | | $17,503.20 | $29,034.90 | $38,962.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,846.65 / $15,846.65 / $40,013.81
| Facility | | $15,846.65 | $15,846.65 | $40,013.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,085.70 / $24,670.12 / $39,473.14
| Facility | | $14,085.70 | $24,670.12 | $39,473.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,372.49 / $23,377.50 / $53,613.96
| Facility | | $14,372.49 | $23,377.50 | $53,613.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,064.02 / $23,028.40 / $32,622.52
| Facility | | $17,064.02 | $23,028.40 | $32,622.52 |