- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,331.40 / $24,282.50 / $42,485.20
| Facility | | $18,331.40 | $24,282.50 | $42,485.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,219.50 / $26,609.09 / $27,087.89
| Facility | | $14,219.50 | $26,609.09 | $27,087.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,707.53 / $19,947.54 / $40,779.54
| Facility | | $5,707.53 | $19,947.54 | $40,779.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,824.05 / $23,297.05 / $37,931.85
| Facility | | $13,824.05 | $23,297.05 | $37,931.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $24,851.11 / $38,221.51
| Facility | | $3,496.00 | $24,851.11 | $38,221.51 |