- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $28,840.32 / $39,810.72
| Facility | | $15,488.17 | $28,840.32 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $23,442.29 / $38,018.94
| Facility | | $15,488.17 | $23,442.29 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $30,902.95 / $42,657.95
| Facility | | $15,135.61 | $30,902.95 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $22,387.21 / $45,708.82
| Facility | | $7,079.46 | $22,387.21 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $22,387.21 / $44,668.36
| Facility | | $6,456.54 | $22,387.21 | $44,668.36 |