- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,572.50 / $26,693.20 / $37,794.80
| Facility | | $14,572.50 | $26,693.20 | $37,794.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,810.28 / $29,151.75 / $47,464.28
| Facility | | $17,810.28 | $29,151.75 | $47,464.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,150.96 / $24,011.98 / $42,721.12
| Facility | | $15,150.96 | $24,011.98 | $42,721.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $23,192.68 / $50,517.80
| Facility | | $7,117.00 | $23,192.68 | $50,517.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $22,161.72 / $44,892.75
| Facility | | $3,308.00 | $22,161.72 | $44,892.75 |