- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,213.20 / $26,742.60 / $45,152.20
| Facility | | $12,213.20 | $26,742.60 | $45,152.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,630.97 / $43,970.32 / $57,015.97
| Facility | | $29,630.97 | $43,970.32 | $57,015.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,659.45 / $38,121.97 / $55,960.92
| Facility | | $26,659.45 | $38,121.97 | $55,960.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,617.56 / $37,695.61 / $79,048.88
| Facility | | $19,617.56 | $37,695.61 | $79,048.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,659.45 / $41,505.69 / $56,269.43
| Facility | | $26,659.45 | $41,505.69 | $56,269.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,723.62 / $35,103.16 / $52,771.40
| Facility | | $7,723.62 | $35,103.16 | $52,771.40 |