- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,363.80 / $29,639.40 / $48,176.50
| Facility | | $17,363.80 | $29,639.40 | $48,176.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,339.00 / $20,850.48 / $25,956.96
| Facility | | $11,339.00 | $20,850.48 | $25,956.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,889.39 / $23,549.98 / $37,152.36
| Facility | | $14,889.39 | $23,549.98 | $37,152.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,138.60 / $18,909.22 / $37,469.49
| Facility | | $9,138.60 | $18,909.22 | $37,469.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,842.00 / $24,596.64 / $33,833.18
| Facility | | $6,842.00 | $24,596.64 | $33,833.18 |