- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,838.40 / $20,337.50 / $31,399.40
| Facility | | $13,838.40 | $20,337.50 | $31,399.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,066.23 / $22,924.06 / $29,277.34
| Facility | | $16,066.23 | $22,924.06 | $29,277.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,574.58 / $30,112.00 / $38,086.23
| Facility | | $15,574.58 | $30,112.00 | $38,086.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,838.40 / $20,801.70 / $33,262.90
| Facility | | $13,838.40 | $20,801.70 | $33,262.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,001.68 / $27,674.50 / $42,045.61
| Facility | | $17,001.68 | $27,674.50 | $42,045.61 |