- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,210.60 / $26,030.40 / $36,856.30
| Facility | | $14,210.60 | $26,030.40 | $36,856.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,775.33 / $25,553.02 / $42,155.78
| Facility | | $15,775.33 | $25,553.02 | $42,155.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,774.76 / $23,415.76 / $41,660.35
| Facility | | $14,774.76 | $23,415.76 | $41,660.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $21,875.56 / $49,263.44
| Facility | | $7,117.00 | $21,875.56 | $49,263.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $21,611.44 / $43,778.06
| Facility | | $3,308.00 | $21,611.44 | $43,778.06 |