- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,740.80 / $29,131.80 / $46,905.90
| Facility | | $12,740.80 | $29,131.80 | $46,905.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $16,563.64 / $41,102.01
| Facility | | $1,474.01 | $16,563.64 | $41,102.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,087.67 / $30,459.17 / $43,149.07
| Facility | | $21,087.67 | $30,459.17 | $43,149.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,306.62 / $24,924.44 / $52,762.78
| Facility | | $17,306.62 | $24,924.44 | $52,762.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,306.62 / $25,546.94 / $54,949.00
| Facility | | $17,306.62 | $25,546.94 | $54,949.00 |