- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,346.70 / $24,447.90 / $34,615.60
| Facility | | $13,346.70 | $24,447.90 | $34,615.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,280.36 / $26,682.38 / $43,055.56
| Facility | | $16,280.36 | $26,682.38 | $43,055.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,876.50 / $21,992.15 / $39,127.53
| Facility | | $13,876.50 | $21,992.15 | $39,127.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $20,888.70 / $46,268.37
| Facility | | $7,117.00 | $20,888.70 | $46,268.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $20,297.54 / $41,116.49
| Facility | | $3,308.00 | $20,297.54 | $41,116.49 |