- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,310.90 / $28,284.50 / $49,390.50
| Facility | | $21,310.90 | $28,284.50 | $49,390.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,105.66 / $17,978.34 / $30,112.10
| Facility | | $14,105.66 | $17,978.34 | $30,112.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $24,093.64 / $47,556.65
| Facility | | $5,939.30 | $24,093.64 | $47,556.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,211.80 / $28,906.30 / $44,097.08
| Facility | | $19,211.80 | $28,906.30 | $44,097.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $32,152.56 / $52,018.51
| Facility | | $3,496.00 | $32,152.56 | $52,018.51 |