- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,639.60 / $21,515.10 / $33,217.50
| Facility | | $14,639.60 | $21,515.10 | $33,217.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,265.70 / $25,683.89 / $29,945.89
| Facility | | $25,265.70 | $25,683.89 | $29,945.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,313.08 / $33,143.03 / $42,491.07
| Facility | | $23,313.08 | $33,143.03 | $42,491.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,476.40 / $31,855.57 / $40,291.53
| Facility | | $16,476.40 | $31,855.57 | $40,291.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,639.60 / $22,006.20 / $35,188.90
| Facility | | $14,639.60 | $22,006.20 | $35,188.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,120.89 / $29,276.93 / $44,480.17
| Facility | | $17,120.89 | $29,276.93 | $44,480.17 |