- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,818.60 / $28,975.80 / $41,026.60
| Facility | | $15,818.60 | $28,975.80 | $41,026.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,615.72 / $31,615.72 / $31,615.72
| Facility | | $31,615.72 | $31,615.72 | $31,615.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,306.59 / $27,842.82 / $44,622.33
| Facility | | $17,306.59 | $27,842.82 | $44,622.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,446.54 / $26,065.27 / $46,374.26
| Facility | | $16,446.54 | $26,065.27 | $46,374.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $24,056.80 / $54,837.65
| Facility | | $7,117.00 | $24,056.80 | $54,837.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $24,056.80 / $48,731.60
| Facility | | $3,308.00 | $24,056.80 | $48,731.60 |