- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,476.20 / $28,124.20 / $45,713.60
| Facility | | $16,476.20 | $28,124.20 | $45,713.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,298.37 / $25,298.37 / $25,298.37
| Facility | | $25,298.37 | $25,298.37 | $25,298.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,128.22 / $22,346.06 / $35,253.08
| Facility | | $14,128.22 | $22,346.06 | $35,253.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,065.99 / $20,093.91 / $36,039.89
| Facility | | $11,065.99 | $20,093.91 | $36,039.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,470.78 / $25,429.44 / $33,852.40
| Facility | | $16,470.78 | $25,429.44 | $33,852.40 |