- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,567.60 / $21,409.30 / $33,054.10
| Facility | | $14,567.60 | $21,409.30 | $33,054.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,255.03 / $35,903.80 / $46,030.51
| Facility | | $25,255.03 | $35,903.80 | $46,030.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,395.37 / $31,698.92 / $40,093.40
| Facility | | $16,395.37 | $31,698.92 | $40,093.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,567.60 / $21,898.00 / $35,015.90
| Facility | | $14,567.60 | $21,898.00 | $35,015.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,036.70 / $29,132.96 / $44,261.44
| Facility | | $17,036.70 | $29,132.96 | $44,261.44 |