- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,387.21 / $38,018.94 / $40,738.03
| Facility | | $22,387.21 | $38,018.94 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,118.86 / $38,018.94 / $52,480.75
| Facility | | $25,118.86 | $38,018.94 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $33,113.11 / $44,668.36
| Facility | | $21,379.62 | $33,113.11 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $28,840.32 / $40,738.03
| Facility | | $19,952.62 | $28,840.32 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $22,387.21 / $53,703.18
| Facility | | $4,466.84 | $22,387.21 | $53,703.18 |