- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,521.90 / $18,402.80 / $28,412.30
| Facility | | $12,521.90 | $18,402.80 | $28,412.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,908.12 / $51,048.76 / $65,447.13
| Facility | | $35,908.12 | $51,048.76 | $65,447.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,092.93 / $27,247.37 / $34,462.99
| Facility | | $14,092.93 | $27,247.37 | $34,462.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,521.90 / $18,822.80 / $30,098.50
| Facility | | $12,521.90 | $18,822.80 | $30,098.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,644.20 / $25,041.76 / $38,045.71
| Facility | | $14,644.20 | $25,041.76 | $38,045.71 |