- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,743.70 / $25,969.50 / $42,985.50
| Facility | | $10,743.70 | $25,969.50 | $42,985.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,165.74 / $46,247.81 / $59,969.18
| Facility | | $31,165.74 | $46,247.81 | $59,969.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,646.00 / $34,496.42 / $55,156.14
| Facility | | $17,646.00 | $34,496.42 | $55,156.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,340.21 / $37,162.68 / $77,931.31
| Facility | | $19,340.21 | $37,162.68 | $77,931.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,648.00 / $36,917.26 / $55,169.76
| Facility | | $17,648.00 | $36,917.26 | $55,169.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $24,701.48 / $47,449.41
| Facility | | $5,281.00 | $24,701.48 | $47,449.41 |