- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,717.20 / $23,156.90 / $40,749.40
| Facility | | $13,717.20 | $23,156.90 | $40,749.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,209.80 / $16,687.79 / $27,438.64
| Facility | | $11,209.80 | $16,687.79 | $27,438.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,477.92 / $21,010.15 / $29,334.65
| Facility | | $12,477.92 | $21,010.15 | $29,334.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41,480.44 / $41,480.44 / $48,680.83
| Facility | | $41,480.44 | $41,480.44 | $48,680.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $20,181.00 / $28,826.27
| Facility | | $1,787.00 | $20,181.00 | $28,826.27 |