- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,968.80 / $29,100.70 / $50,915.20
| Facility | | $21,968.80 | $29,100.70 | $50,915.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,090.06 / $23,355.38 / $32,441.36
| Facility | | $22,090.06 | $23,355.38 | $32,441.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $24,436.86 / $49,600.92
| Facility | | $5,939.30 | $24,436.86 | $49,600.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,567.03 / $27,919.68 / $45,458.33
| Facility | | $16,567.03 | $27,919.68 | $45,458.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $29,989.64 / $45,805.46
| Facility | | $3,496.00 | $29,989.64 | $45,805.46 |