- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,457.20 / $30,145.60 / $42,682.90
| Facility | | $16,457.20 | $30,145.60 | $42,682.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,853.00 / $28,343.66 / $44,556.33
| Facility | | $17,853.00 | $28,343.66 | $44,556.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,110.50 / $27,117.55 / $48,246.43
| Facility | | $17,110.50 | $27,117.55 | $48,246.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $25,025.28 / $57,051.49
| Facility | | $7,117.00 | $25,025.28 | $57,051.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $25,028.00 / $50,698.93
| Facility | | $3,308.00 | $25,028.00 | $50,698.93 |