- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,331.40 / $28,218.80 / $49,657.00
| Facility | | $14,331.40 | $28,218.80 | $49,657.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,518.18 / $21,436.39 / $35,246.46
| Facility | | $14,518.18 | $21,436.39 | $35,246.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,205.52 / $25,579.62 / $35,097.51
| Facility | | $15,205.52 | $25,579.62 | $35,097.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52,255.35 / $52,255.35 / $61,326.09
| Facility | | $52,255.35 | $52,255.35 | $61,326.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,520.00 / $22,410.24 / $34,939.49
| Facility | | $2,520.00 | $22,410.24 | $34,939.49 |