- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,485.80 / $21,125.10 / $34,292.69
| Facility | | $14,485.80 | $21,125.10 | $34,292.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,313.65 / $48,781.98 / $62,541.00
| Facility | | $34,313.65 | $48,781.98 | $62,541.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,009.73 / $32,886.73 / $41,595.76
| Facility | | $17,009.73 | $32,886.73 | $41,595.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,113.50 / $22,718.60 / $36,328.00
| Facility | | $15,113.50 | $22,718.60 | $36,328.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,675.09 / $30,224.62 / $45,919.99
| Facility | | $17,675.09 | $30,224.62 | $45,919.99 |