- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,648.80 / $37,823.60 / $53,554.10
| Facility | | $20,648.80 | $37,823.60 | $53,554.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,144.79 / $40,316.32 / $63,362.42
| Facility | | $25,144.79 | $40,316.32 | $63,362.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,118.00 / $28,497.78 / $60,534.61
| Facility | | $13,118.00 | $28,497.78 | $60,534.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,713.00 / $31,512.90 / $71,582.28
| Facility | | $6,713.00 | $31,512.90 | $71,582.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $26,246.84 / $60,027.20
| Facility | | $3,308.00 | $26,246.84 | $60,027.20 |