- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,127.50 / $27,143.30 / $45,064.30
| Facility | | $17,127.50 | $27,143.30 | $45,064.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,628.58 / $23,412.53 / $39,661.31
| Facility | | $15,628.58 | $23,412.53 | $39,661.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,396.66 / $28,951.45 / $41,628.65
| Facility | | $23,396.66 | $28,951.45 | $41,628.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,988.20 / $27,811.17 / $69,884.81
| Facility | | $13,988.20 | $27,811.17 | $69,884.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,988.20 / $27,750.67 / $39,002.19
| Facility | | $13,988.20 | $27,750.67 | $39,002.19 |