- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,995.09 / $29,850.80 / $40,057.50
| Facility | | $17,995.09 | $29,850.80 | $40,057.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,599.41 / $19,599.41 / $24,414.24
| Facility | | $19,599.41 | $19,599.41 | $24,414.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,206.05 / $24,743.86 / $38,259.93
| Facility | | $14,206.05 | $24,743.86 | $38,259.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,776.41 / $24,034.50 / $55,120.72
| Facility | | $14,776.41 | $24,034.50 | $55,120.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,504.96 / $22,948.14 / $33,258.94
| Facility | | $13,504.96 | $22,948.14 | $33,258.94 |