- 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
- $11,258.00 / $11,258.00 / $26,953.00
| Facility | | $11,258.00 | $11,258.00 | $26,953.00 |
- 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
- $7,685.21 / $16,107.73 / $34,154.91
| Facility | | $7,685.21 | $16,107.73 | $34,154.91 |
- 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 |