- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,913.50 / $25,486.30 / $36,085.80
| Facility | | $13,913.50 | $25,486.30 | $36,085.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,572.18 / $26,782.28 / $42,596.77
| Facility | | $16,572.18 | $26,782.28 | $42,596.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,465.88 / $24,881.00 / $40,789.40
| Facility | | $14,465.88 | $24,881.00 | $40,789.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $22,240.19 / $48,233.54
| Facility | | $7,117.00 | $22,240.19 | $48,233.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $21,159.64 / $42,862.84
| Facility | | $3,308.00 | $21,159.64 | $42,862.84 |