- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,618.90 / $24,679.10 / $43,428.10
| Facility | | $14,618.90 | $24,679.10 | $43,428.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,951.58 / $19,123.27 / $31,443.14
| Facility | | $12,951.58 | $19,123.27 | $31,443.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,298.18 / $22,370.98 / $30,941.82
| Facility | | $13,298.18 | $22,370.98 | $30,941.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,653.45 / $43,653.45 / $51,231.03
| Facility | | $43,653.45 | $43,653.45 | $51,231.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $21,507.64 / $30,721.21
| Facility | | $1,787.00 | $21,507.64 | $30,721.21 |