- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,400.80 / $19,694.40 / $30,406.50
| Facility | | $13,400.80 | $19,694.40 | $30,406.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41,495.28 / $58,991.74 / $75,630.42
| Facility | | $41,495.28 | $58,991.74 | $75,630.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,082.11 / $29,159.84 / $36,881.93
| Facility | | $15,082.11 | $29,159.84 | $36,881.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,400.80 / $20,144.00 / $32,211.10
| Facility | | $13,400.80 | $20,144.00 | $32,211.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,672.06 / $26,799.42 / $40,716.11
| Facility | | $15,672.06 | $26,799.42 | $40,716.11 |