- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $36,307.81 / $52,480.75
| Facility | | $13,803.84 | $36,307.81 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,673.69 / $34,673.69 / $44,668.36
| Facility | | $34,673.69 | $34,673.69 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $40,738.03 / $69,183.10
| Facility | | $28,183.83 | $40,738.03 | $69,183.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,442.29 / $39,810.72 / $69,183.10
| Facility | | $23,442.29 | $39,810.72 | $69,183.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $28,840.32 / $56,234.13
| Facility | | $20,892.96 | $28,840.32 | $56,234.13 |