- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,442.29 / $39,810.72 / $42,657.95
| Facility | | $23,442.29 | $39,810.72 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,302.68 / $39,810.72 / $54,954.09
| Facility | | $26,302.68 | $39,810.72 | $54,954.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $31,622.78 / $47,863.01
| Facility | | $16,218.10 | $31,622.78 | $47,863.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $28,840.32 / $43,651.58
| Facility | | $15,488.17 | $28,840.32 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $34,673.69 / $57,543.99
| Facility | | $4,073.80 | $34,673.69 | $57,543.99 |