- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $28,840.32 / $54,954.09
| Facility | | $18,620.87 | $28,840.32 | $54,954.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $11,748.98 / $28,183.83
| Facility | | $11,748.98 | $11,748.98 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $24,547.09 / $39,810.72
| Facility | | $16,218.10 | $24,547.09 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $20,892.96 / $39,810.72
| Facility | | $9,772.37 | $20,892.96 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $28,183.83 / $38,018.94
| Facility | | $15,488.17 | $28,183.83 | $38,018.94 |