- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,497.20 / $24,090.80 / $31,663.50
| Facility | | $16,497.20 | $24,090.80 | $31,663.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,611.71 / $15,282.81 / $25,848.82
| Facility | | $5,611.71 | $15,282.81 | $25,848.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,758.84 / $24,197.81 / $40,501.67
| Facility | | $16,758.84 | $24,197.81 | $40,501.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,751.18 / $27,005.08 / $39,429.61
| Facility | | $20,751.18 | $27,005.08 | $39,429.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,751.18 / $25,104.82 / $39,429.61
| Facility | | $20,751.18 | $25,104.82 | $39,429.61 |