- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,813.30 / $28,894.70 / $50,554.80
| Facility | | $21,813.30 | $28,894.70 | $50,554.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,518.04 / $23,310.85 / $33,104.98
| Facility | | $16,518.04 | $23,310.85 | $33,104.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $25,576.85 / $49,984.23
| Facility | | $5,939.30 | $25,576.85 | $49,984.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,449.77 / $27,722.06 / $45,136.58
| Facility | | $16,449.77 | $27,722.06 | $45,136.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $29,777.37 / $45,481.25
| Facility | | $3,496.00 | $29,777.37 | $45,481.25 |