- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,821.50 / $25,317.60 / $35,847.10
| Facility | | $13,821.50 | $25,317.60 | $35,847.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,713.48 / $25,181.05 / $41,641.14
| Facility | | $15,713.48 | $25,181.05 | $41,641.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,370.18 / $22,774.56 / $40,519.55
| Facility | | $14,370.18 | $22,774.56 | $40,519.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $21,420.57 / $47,914.45
| Facility | | $7,117.00 | $21,420.57 | $47,914.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $21,019.65 / $42,579.28
| Facility | | $3,308.00 | $21,019.65 | $42,579.28 |