- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,395.59 / $30,032.80 / $42,523.20
| Facility | | $16,395.59 | $30,032.80 | $42,523.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,421.00 / $31,238.77 / $49,726.58
| Facility | | $19,421.00 | $31,238.77 | $49,726.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,046.48 / $27,016.09 / $48,065.91
| Facility | | $17,046.48 | $27,016.09 | $48,065.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $26,207.67 / $56,838.03
| Facility | | $7,117.00 | $26,207.67 | $56,838.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $24,934.35 / $50,509.24
| Facility | | $3,308.00 | $24,934.35 | $50,509.24 |