- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $30,902.95 / $40,738.03
| Facility | | $19,054.61 | $30,902.95 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,902.95 / $45,708.82 / $56,234.13
| Facility | | $30,902.95 | $45,708.82 | $56,234.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,153.52 / $37,153.52 / $37,153.52
| Facility | | $37,153.52 | $37,153.52 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $30,199.52 / $40,738.03
| Facility | | $20,417.38 | $30,199.52 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,153.52 / $37,153.52 / $37,153.52
| Facility | | $37,153.52 | $37,153.52 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $25,703.96 / $42,657.95
| Facility | | $17,378.01 | $25,703.96 | $42,657.95 |