- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,837.70 / $28,424.80 / $50,019.40
| Facility | | $16,837.70 | $28,424.80 | $50,019.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,697.22 / $23,226.29 / $38,422.66
| Facility | | $15,697.22 | $23,226.29 | $38,422.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,877.28 / $25,766.33 / $35,353.69
| Facility | | $14,877.28 | $25,766.33 | $35,353.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,761.20 / $30,761.20 / $36,100.87
| Facility | | $30,761.20 | $30,761.20 | $36,100.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $24,771.97 / $35,383.92
| Facility | | $1,787.00 | $24,771.97 | $35,383.92 |