- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,528.70 / $25,868.50 / $45,260.10
| Facility | | $19,528.70 | $25,868.50 | $45,260.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,579.97 / $20,628.68 / $26,983.82
| Facility | | $12,579.97 | $20,628.68 | $26,983.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $21,510.00 / $43,973.72
| Facility | | $5,939.30 | $21,510.00 | $43,973.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,739.00 / $26,488.92 / $40,409.33
| Facility | | $17,739.00 | $26,488.92 | $40,409.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $25,792.00 / $40,717.91
| Facility | | $3,496.00 | $25,792.00 | $40,717.91 |