- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,030.80 / $24,870.10 / $32,687.80
| Facility | | $17,030.80 | $24,870.10 | $32,687.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,302.20 / $25,333.40 / $42,848.03
| Facility | | $9,302.20 | $25,333.40 | $42,848.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,925.73 / $25,095.72 / $44,763.67
| Facility | | $17,925.73 | $25,095.72 | $44,763.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,422.46 / $27,878.67 / $40,705.12
| Facility | | $21,422.46 | $27,878.67 | $40,705.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,422.46 / $25,916.94 / $40,705.12
| Facility | | $21,422.46 | $25,916.94 | $40,705.12 |