- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,422.50 / $28,032.50 / $45,564.60
| Facility | | $16,422.50 | $28,032.50 | $45,564.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,339.00 / $12,845.96 / $22,397.76
| Facility | | $11,339.00 | $12,845.96 | $22,397.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,082.15 / $22,273.20 / $35,138.12
| Facility | | $14,082.15 | $22,273.20 | $35,138.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,474.87 / $17,132.46 / $35,438.06
| Facility | | $8,474.87 | $17,132.46 | $35,438.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,417.07 / $25,349.22 / $37,331.82
| Facility | | $16,417.07 | $25,349.22 | $37,331.82 |