- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,782.70 / $24,955.60 / $43,914.70
| Facility | | $14,782.70 | $24,955.60 | $43,914.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,440.68 / $25,533.91 / $41,932.04
| Facility | | $17,440.68 | $25,533.91 | $41,932.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,447.18 / $22,621.63 / $31,233.77
| Facility | | $13,447.18 | $22,621.63 | $31,233.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52,083.10 / $52,083.10 / $61,123.94
| Facility | | $52,083.10 | $52,083.10 | $61,123.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,520.00 / $20,342.34 / $30,899.15
| Facility | | $2,520.00 | $20,342.34 | $30,899.15 |