- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,991.60 / $25,308.30 / $44,535.40
| Facility | | $14,991.60 | $25,308.30 | $44,535.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,885.78 / $22,025.65 / $36,084.07
| Facility | | $14,885.78 | $22,025.65 | $36,084.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,637.23 / $22,941.34 / $31,606.14
| Facility | | $13,637.23 | $22,941.34 | $31,606.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50,689.20 / $50,689.20 / $59,488.08
| Facility | | $50,689.20 | $50,689.20 | $59,488.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,158.00 / $22,556.00 / $36,891.55
| Facility | | $3,158.00 | $22,556.00 | $36,891.55 |