- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,383.20 / $20,975.50 / $34,049.80
| Facility | | $14,383.20 | $20,975.50 | $34,049.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,863.04 / $25,194.79 / $38,443.62
| Facility | | $21,863.04 | $25,194.79 | $38,443.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,200.42 / $40,091.11 / $51,398.86
| Facility | | $28,200.42 | $40,091.11 | $51,398.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,889.25 / $32,653.80 / $41,301.14
| Facility | | $16,889.25 | $32,653.80 | $41,301.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,006.50 / $22,557.70 / $36,070.69
| Facility | | $15,006.50 | $22,557.70 | $36,070.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,549.90 / $30,010.55 / $45,594.74
| Facility | | $17,549.90 | $30,010.55 | $45,594.74 |