- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.50 / $21,371.70 / $35,768.69
| Facility | | $15,488.50 | $21,371.70 | $35,768.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,936.20 / $30,936.20 / $30,936.20
| Facility | | $30,936.20 | $30,936.20 | $30,936.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,272.00 / $24,142.21 / $37,182.92
| Facility | | $3,272.00 | $24,142.21 | $37,182.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,852.41 / $24,044.13 / $40,321.86
| Facility | | $15,852.41 | $24,044.13 | $40,321.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,062.00 / $24,518.62 / $43,149.13
| Facility | | $4,062.00 | $24,518.62 | $43,149.13 |