- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,076.20 / $17,747.70 / $27,400.90
| Facility | | $12,076.20 | $17,747.70 | $27,400.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,205.26 / $51,471.19 / $65,988.70
| Facility | | $36,205.26 | $51,471.19 | $65,988.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,591.30 / $26,277.51 / $33,236.29
| Facility | | $13,591.30 | $26,277.51 | $33,236.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,076.20 / $18,152.80 / $29,027.20
| Facility | | $12,076.20 | $18,152.80 | $29,027.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,122.94 / $24,150.40 / $36,691.48
| Facility | | $14,122.94 | $24,150.40 | $36,691.48 |