- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,454.20 / $22,567.80 / $29,661.80
| Facility | | $15,454.20 | $22,567.80 | $29,661.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,683.29 / $27,467.54 / $49,879.27
| Facility | | $9,683.29 | $27,467.54 | $49,879.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,266.29 / $22,772.52 / $40,619.75
| Facility | | $16,266.29 | $22,772.52 | $40,619.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,439.31 / $25,297.85 / $36,936.92
| Facility | | $19,439.31 | $25,297.85 | $36,936.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,439.31 / $23,517.72 / $36,936.92
| Facility | | $19,439.31 | $23,517.72 | $36,936.92 |