- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,415.70 / $27,712.30 / $48,765.70
| Facility | | $16,415.70 | $27,712.30 | $48,765.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,284.56 / $20,913.21 / $34,578.82
| Facility | | $14,284.56 | $20,913.21 | $34,578.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,504.39 / $25,120.51 / $34,467.57
| Facility | | $14,504.39 | $25,120.51 | $34,467.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57,836.25 / $57,836.25 / $67,875.75
| Facility | | $57,836.25 | $57,836.25 | $67,875.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $24,151.07 / $34,497.04
| Facility | | $1,787.00 | $24,151.07 | $34,497.04 |