- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $22,387.21 / $42,657.95
| Facility | | $14,454.40 | $22,387.21 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $22,387.21 / $23,988.33
| Facility | | $12,022.64 | $22,387.21 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $19,054.61 / $30,902.95
| Facility | | $12,589.25 | $19,054.61 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $10,964.78 / $30,902.95
| Facility | | $3,801.89 | $10,964.78 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $21,877.62 / $30,199.52
| Facility | | $12,882.50 | $21,877.62 | $30,199.52 |