- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,473.70 / $28,120.00 / $45,706.80
| Facility | | $16,473.70 | $28,120.00 | $45,706.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,258.00 / $11,258.00 / $25,563.98
| Facility | | $11,258.00 | $11,258.00 | $25,563.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,073.51 / $22,342.75 / $35,247.85
| Facility | | $14,073.51 | $22,342.75 | $35,247.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,296.57 / $18,884.83 / $35,548.72
| Facility | | $9,296.57 | $18,884.83 | $35,548.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,468.34 / $25,425.67 / $33,847.37
| Facility | | $16,468.34 | $25,425.67 | $33,847.37 |