- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,527.50 / $33,332.60 / $54,179.50
| Facility | | $19,527.50 | $33,332.60 | $54,179.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,177.00 / $22,728.08 / $35,593.44
| Facility | | $11,177.00 | $22,728.08 | $35,593.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,744.66 / $26,484.41 / $41,781.71
| Facility | | $16,744.66 | $26,484.41 | $41,781.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,430.79 / $21,564.96 / $42,138.36
| Facility | | $10,430.79 | $21,564.96 | $42,138.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,842.00 / $27,661.49 / $38,048.94
| Facility | | $6,842.00 | $27,661.49 | $38,048.94 |