- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $23,442.29 / $30,902.95
| Facility | | $14,454.40 | $23,442.29 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,118.86 / $37,153.52 / $45,708.82
| Facility | | $25,118.86 | $37,153.52 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $28,183.83 / $28,183.83
| Facility | | $28,183.83 | $28,183.83 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $21,877.62 / $29,512.09
| Facility | | $15,135.61 | $21,877.62 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $28,183.83 / $28,183.83
| Facility | | $28,183.83 | $28,183.83 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $19,498.45 / $32,359.37
| Facility | | $12,589.25 | $19,498.45 | $32,359.37 |