- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,889.60 / $29,317.80 / $51,590.90
| Facility | | $14,889.60 | $29,317.80 | $51,590.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,836.32 / $28,260.94 / $46,106.34
| Facility | | $18,836.32 | $28,260.94 | $46,106.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,797.72 / $26,575.84 / $36,464.42
| Facility | | $15,797.72 | $26,575.84 | $36,464.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53,310.05 / $53,310.05 / $62,563.87
| Facility | | $53,310.05 | $53,310.05 | $62,563.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,891.00 / $34,284.49 / $48,627.54
| Facility | | $3,891.00 | $34,284.49 | $48,627.54 |