- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,103.40 / $19,257.40 / $29,731.80
| Facility | | $13,103.40 | $19,257.40 | $29,731.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,723.22 / $52,207.55 / $66,932.75
| Facility | | $36,723.22 | $52,207.55 | $66,932.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,747.45 / $28,512.82 / $36,063.55
| Facility | | $14,747.45 | $28,512.82 | $36,063.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,103.40 / $19,697.00 / $31,496.40
| Facility | | $13,103.40 | $19,697.00 | $31,496.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,245.87 / $26,204.77 / $39,812.66
| Facility | | $17,245.87 | $26,204.77 | $39,812.66 |