- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,794.70 / $15,864.50 / $24,493.40
| Facility | | $10,794.70 | $15,864.50 | $24,493.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,512.51 / $66,124.48 / $84,774.97
| Facility | | $46,512.51 | $66,124.48 | $84,774.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,149.11 / $23,489.16 / $29,709.53
| Facility | | $12,149.11 | $23,489.16 | $29,709.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,794.70 / $16,226.60 / $25,947.00
| Facility | | $10,794.70 | $16,226.60 | $25,947.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,624.33 / $21,587.76 / $32,798.08
| Facility | | $12,624.33 | $21,587.76 | $32,798.08 |