- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,062.10 / $28,614.70 / $45,055.70
| Facility | | $21,062.10 | $28,614.70 | $45,055.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,317.92 / $25,432.81 / $38,067.68
| Facility | | $16,317.92 | $25,432.81 | $38,067.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,373.98 / $25,772.70 / $45,912.00
| Facility | | $18,373.98 | $25,772.70 | $45,912.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $261.86 / $428.75
| Facility | | $150.00 | $261.86 | $428.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,238.00 / $28,008.62 / $46,095.65
| Facility | | $20,238.00 | $28,008.62 | $46,095.65 |