- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,568.30 / $26,765.70 / $37,036.80
| Facility | | $16,568.30 | $26,765.70 | $37,036.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,274.54 / $46,274.54 / $46,274.54
| Facility | | $46,274.54 | $46,274.54 | $46,274.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,109.33 / $24,210.56 / $36,679.51
| Facility | | $15,109.33 | $24,210.56 | $36,679.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,987.03 / $24,748.54 / $38,335.56
| Facility | | $15,987.03 | $24,748.54 | $38,335.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,550.23 / $23,784.38 / $36,278.69
| Facility | | $14,550.23 | $23,784.38 | $36,278.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,403.00 / $28,816.89 / $41,167.53
| Facility | | $10,403.00 | $28,816.89 | $41,167.53 |