- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,555.40 / $31,477.20 / $41,371.90
| Facility | | $21,555.40 | $31,477.20 | $41,371.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,595.88 / $37,026.72 / $62,625.70
| Facility | | $13,595.88 | $37,026.72 | $62,625.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,688.02 / $31,762.84 / $56,655.93
| Facility | | $22,688.02 | $31,762.84 | $56,655.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,113.72 / $35,285.12 / $51,519.17
| Facility | | $27,113.72 | $35,285.12 | $51,519.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,113.72 / $32,802.24 / $51,519.17
| Facility | | $27,113.72 | $32,802.24 | $51,519.17 |