- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,240.70 / $25,728.80 / $45,275.20
| Facility | | $15,240.70 | $25,728.80 | $45,275.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,574.31 / $28,893.61 / $48,604.48
| Facility | | $19,574.31 | $28,893.61 | $48,604.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,863.77 / $23,322.44 / $32,050.01
| Facility | | $13,863.77 | $23,322.44 | $32,050.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,006.65 / $46,006.65 / $53,992.71
| Facility | | $46,006.65 | $46,006.65 | $53,992.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,520.00 / $24,464.94 / $55,700.00
| Facility | | $2,520.00 | $24,464.94 | $55,700.00 |