- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,794.00 / $28,011.00 / $50,608.80
| Facility | | $8,794.00 | $28,011.00 | $50,608.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,593.50 / $24,580.47 / $32,461.28
| Facility | | $21,593.50 | $24,580.47 | $32,461.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,582.87 / $25,919.17 / $41,998.01
| Facility | | $15,582.87 | $25,919.17 | $41,998.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,092.30 / $22,114.20 / $39,553.99
| Facility | | $12,092.30 | $22,114.20 | $39,553.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,234.54 / $28,697.82 / $37,620.87
| Facility | | $18,234.54 | $28,697.82 | $37,620.87 |