- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,742.20 / $30,667.70 / $43,422.20
| Facility | | $16,742.20 | $30,667.70 | $43,422.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,270.50 / $30,886.76 / $48,900.44
| Facility | | $19,270.50 | $30,886.76 | $48,900.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,406.84 / $27,587.20 / $49,082.01
| Facility | | $17,406.84 | $27,587.20 | $49,082.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $26,028.50 / $58,039.57
| Facility | | $7,117.00 | $26,028.50 | $58,039.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $25,461.46 / $51,576.99
| Facility | | $3,308.00 | $25,461.46 | $51,576.99 |