- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,498.80 / $25,828.90 / $45,190.80
| Facility | | $19,498.80 | $25,828.90 | $45,190.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,389.72 / $21,295.84 / $33,474.35
| Facility | | $18,389.72 | $21,295.84 | $33,474.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $23,171.90 / $45,226.93
| Facility | | $5,939.30 | $23,171.90 | $45,226.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,704.40 / $24,780.67 / $40,347.44
| Facility | | $14,704.40 | $24,780.67 | $40,347.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $26,617.91 / $40,655.56
| Facility | | $3,496.00 | $26,617.91 | $40,655.56 |