- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,287.60 / $24,339.70 / $34,462.40
| Facility | | $13,287.60 | $24,339.70 | $34,462.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,242.87 / $24,434.33 / $38,451.26
| Facility | | $15,242.87 | $24,434.33 | $38,451.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,815.12 / $21,894.87 / $38,954.44
| Facility | | $13,815.12 | $21,894.87 | $38,954.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $21,013.16 / $46,063.71
| Facility | | $7,117.00 | $21,013.16 | $46,063.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $18,786.16 / $40,934.62
| Facility | | $3,308.00 | $18,786.16 | $40,934.62 |