- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,827.80 / $27,017.50 / $43,914.80
| Facility | | $15,827.80 | $27,017.50 | $43,914.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,231.00 / $24,223.22 / $28,136.35
| Facility | | $11,231.00 | $24,223.22 | $28,136.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,572.26 / $21,466.73 / $33,865.83
| Facility | | $13,572.26 | $21,466.73 | $33,865.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,767.26 / $23,607.88 / $43,307.20
| Facility | | $12,767.26 | $23,607.88 | $43,307.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,553.00 / $22,420.80 / $30,840.27
| Facility | | $6,553.00 | $22,420.80 | $30,840.27 |