- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,597.20 / $28,803.50 / $46,377.20
| Facility | | $12,597.20 | $28,803.50 | $46,377.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $15,042.81 / $40,663.71
| Facility | | $1,474.01 | $15,042.81 | $40,663.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,850.00 / $30,115.87 / $42,662.75
| Facility | | $20,850.00 | $30,115.87 | $42,662.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,111.56 / $24,643.52 / $45,539.02
| Facility | | $17,111.56 | $24,643.52 | $45,539.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,111.56 / $25,259.01 / $53,731.98
| Facility | | $17,111.56 | $25,259.01 | $53,731.98 |