- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,647.80 / $21,361.40 / $34,676.19
| Facility | | $14,647.80 | $21,361.40 | $34,676.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,907.76 / $36,831.75 / $47,220.19
| Facility | | $25,907.76 | $36,831.75 | $47,220.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,199.96 / $33,697.56 / $45,619.54
| Facility | | $17,199.96 | $33,697.56 | $45,619.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,282.50 / $22,972.60 / $36,734.19
| Facility | | $15,282.50 | $22,972.60 | $36,734.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,872.75 / $30,562.63 / $46,433.53
| Facility | | $17,872.75 | $30,562.63 | $46,433.53 |