- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,369.40 / $20,955.40 / $34,017.19
| Facility | | $14,369.40 | $20,955.40 | $34,017.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,345.16 / $30,345.33 / $38,904.26
| Facility | | $21,345.16 | $30,345.33 | $38,904.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,873.05 / $32,622.47 / $41,261.51
| Facility | | $16,873.05 | $32,622.47 | $41,261.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,992.10 / $22,536.00 / $36,036.10
| Facility | | $14,992.10 | $22,536.00 | $36,036.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,533.06 / $29,981.75 / $45,551.00
| Facility | | $17,533.06 | $29,981.75 | $45,551.00 |