- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,115.50 / $25,074.10 / $33,647.50
| Facility | | $15,115.50 | $25,074.10 | $33,647.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,140.37 / $14,140.37 / $14,140.37
| Facility | | $14,140.37 | $14,140.37 | $14,140.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,456.03 / $21,815.88 / $34,906.24
| Facility | | $12,456.03 | $21,815.88 | $34,906.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,411.89 / $20,188.50 / $46,300.31
| Facility | | $12,411.89 | $20,188.50 | $46,300.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,736.26 / $19,887.02 / $28,172.38
| Facility | | $14,736.26 | $19,887.02 | $28,172.38 |