- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,483.50 / $24,722.80 / $40,184.90
| Facility | | $14,483.50 | $24,722.80 | $40,184.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,231.00 / $22,423.76 / $23,600.93
| Facility | | $11,231.00 | $22,423.76 | $23,600.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,494.24 / $19,643.47 / $30,989.48
| Facility | | $12,494.24 | $19,643.47 | $30,989.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,602.26 / $18,910.64 / $34,835.85
| Facility | | $10,602.26 | $18,910.64 | $34,835.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,478.76 / $22,353.94 / $29,758.20
| Facility | | $14,478.76 | $22,353.94 | $29,758.20 |