- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,984.80 / $17,613.40 / $27,193.60
| Facility | | $11,984.80 | $17,613.40 | $27,193.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,854.97 / $42,443.30 / $54,414.49
| Facility | | $29,854.97 | $42,443.30 | $54,414.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,488.44 / $26,078.63 / $32,984.75
| Facility | | $13,488.44 | $26,078.63 | $32,984.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,984.80 / $18,015.40 / $28,807.50
| Facility | | $11,984.80 | $18,015.40 | $28,807.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,016.05 / $23,967.63 / $36,413.79
| Facility | | $14,016.05 | $23,967.63 | $36,413.79 |