- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,737.50 / $30,730.20 / $41,237.50
| Facility | | $16,737.50 | $30,730.20 | $41,237.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,291.00 / $19,569.08 / $46,130.64
| Facility | | $8,291.00 | $19,569.08 | $46,130.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,231.09 / $25,030.29 / $39,040.14
| Facility | | $12,231.09 | $25,030.29 | $39,040.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,211.69 / $24,742.50 / $56,744.45
| Facility | | $15,211.69 | $24,742.50 | $56,744.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,886.00 / $21,443.50 / $32,825.05
| Facility | | $12,886.00 | $21,443.50 | $32,825.05 |