- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,153.50 / $31,281.60 / $31,281.60
| Facility | | $28,153.50 | $31,281.60 | $31,281.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,787.14 / $14,409.17 / $28,976.76
| Facility | | $13,787.14 | $14,409.17 | $28,976.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,535.63 / $22,104.04 / $45,470.59
| Facility | | $12,535.63 | $22,104.04 | $45,470.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,662.00 / $34,442.08 / $54,128.15
| Facility | | $20,662.00 | $34,442.08 | $54,128.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $46,733.99 / $60,341.40
| Facility | | $6,965.00 | $46,733.99 | $60,341.40 |