- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $28,183.83 / $42,657.95
| Facility | | $20,892.96 | $28,183.83 | $42,657.95 |
- 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
- $14,454.40 / $25,118.86 / $41,686.94
| Facility | | $14,454.40 | $25,118.86 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $33,113.11 / $43,651.58
| Facility | | $21,877.62 | $33,113.11 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $33,113.11 / $50,118.72
| Facility | | $18,197.01 | $33,113.11 | $50,118.72 |