- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,096.10 / $25,484.70 / $44,845.70
| Facility | | $15,096.10 | $25,484.70 | $44,845.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,139.18 / $25,504.64 / $41,609.57
| Facility | | $17,139.18 | $25,504.64 | $41,609.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,732.25 / $23,101.20 / $31,792.33
| Facility | | $13,732.25 | $23,101.20 | $31,792.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51,362.30 / $51,362.30 / $60,278.02
| Facility | | $51,362.30 | $51,362.30 | $60,278.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,520.00 / $23,732.00 / $31,724.00
| Facility | | $2,520.00 | $23,732.00 | $31,724.00 |