- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,390.20 / $22,618.20 / $34,920.50
| Facility | | $15,390.20 | $22,618.20 | $34,920.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,067.68 / $42,745.69 / $54,802.17
| Facility | | $30,067.68 | $42,745.69 | $54,802.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,321.14 / $33,488.80 / $42,357.28
| Facility | | $17,321.14 | $33,488.80 | $42,357.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,390.20 / $23,134.50 / $36,993.00
| Facility | | $15,390.20 | $23,134.50 | $36,993.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,998.68 / $30,777.96 / $46,760.67
| Facility | | $17,998.68 | $30,777.96 | $46,760.67 |