- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,129.60 / $29,545.60 / $41,833.40
| Facility | | $16,129.60 | $29,545.60 | $41,833.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,916.72 / $34,743.32 / $58,377.65
| Facility | | $19,916.72 | $34,743.32 | $58,377.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,769.93 / $27,412.00 / $47,286.15
| Facility | | $16,769.93 | $27,412.00 | $47,286.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $25,325.16 / $55,915.96
| Facility | | $7,117.00 | $25,325.16 | $55,915.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $25,076.14 / $49,689.84
| Facility | | $3,308.00 | $25,076.14 | $49,689.84 |