- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,079.50 / $24,890.80 / $28,167.90
| Facility | | $16,079.50 | $24,890.80 | $28,167.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,231.91 / $24,550.30 / $33,157.03
| Facility | | $16,231.91 | $24,550.30 | $33,157.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,838.24 / $20,452.86 / $31,223.80
| Facility | | $14,838.24 | $20,452.86 | $31,223.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,056.00 / $20,738.00 / $29,832.00
| Facility | | $14,056.00 | $20,738.00 | $29,832.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,008.00 / $21,212.47 / $38,194.67
| Facility | | $4,008.00 | $21,212.47 | $38,194.67 |