- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,777.70 / $27,831.40 / $37,347.50
| Facility | | $16,777.70 | $27,831.40 | $37,347.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,278.11 / $19,278.11 / $22,547.30
| Facility | | $19,278.11 | $19,278.11 | $22,547.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,871.49 / $22,377.98 / $35,805.62
| Facility | | $12,871.49 | $22,377.98 | $35,805.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,776.75 / $22,408.50 / $51,391.65
| Facility | | $13,776.75 | $22,408.50 | $51,391.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,692.11 / $21,991.70 / $31,655.74
| Facility | | $15,692.11 | $21,991.70 | $31,655.74 |