- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,111.60 / $19,269.40 / $29,750.30
| Facility | | $13,111.60 | $19,269.40 | $29,750.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,801.02 / $26,209.75 / $42,027.59
| Facility | | $20,801.02 | $26,209.75 | $42,027.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,411.10 / $37,547.33 / $48,137.60
| Facility | | $26,411.10 | $37,547.33 | $48,137.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,756.61 / $28,530.52 / $36,085.94
| Facility | | $14,756.61 | $28,530.52 | $36,085.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,111.60 / $19,709.20 / $31,515.90
| Facility | | $13,111.60 | $19,709.20 | $31,515.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,333.83 / $26,221.05 / $39,837.39
| Facility | | $15,333.83 | $26,221.05 | $39,837.39 |