- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,520.30 / $24,512.60 / $43,135.20
| Facility | | $14,520.30 | $24,512.60 | $43,135.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,058.79 / $16,190.54 / $26,847.92
| Facility | | $11,058.79 | $16,190.54 | $26,847.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,208.48 / $22,220.07 / $30,766.06
| Facility | | $13,208.48 | $22,220.07 | $30,766.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,396.40 / $43,396.40 / $50,929.36
| Facility | | $43,396.40 | $43,396.40 | $50,929.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $21,362.56 / $30,513.98
| Facility | | $1,787.00 | $21,362.56 | $30,513.98 |