- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,835.60 / $24,775.60 / $39,891.90
| Facility | | $10,835.60 | $24,775.60 | $39,891.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $12,342.31 / $34,244.51
| Facility | | $1,474.01 | $12,342.31 | $34,244.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,934.36 / $25,904.50 / $36,696.83
| Facility | | $17,934.36 | $25,904.50 | $36,696.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,676.60 / $21,726.82 / $45,629.00
| Facility | | $15,676.60 | $21,726.82 | $45,629.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,718.70 / $21,726.82 / $46,218.16
| Facility | | $14,718.70 | $21,726.82 | $46,218.16 |