- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,193.70 / $29,678.40 / $45,243.10
| Facility | | $15,193.70 | $29,678.40 | $45,243.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,787.83 / $31,780.54 / $50,000.00
| Facility | | $19,787.83 | $31,780.54 | $50,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,136.80 / $28,595.69 / $51,140.28
| Facility | | $18,136.80 | $28,595.69 | $51,140.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,896.00 / $25,707.36 / $55,822.95
| Facility | | $7,896.00 | $25,707.36 | $55,822.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,264.00 / $24,319.80 / $53,739.89
| Facility | | $5,264.00 | $24,319.80 | $53,739.89 |