- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $25,118.86 / $33,113.11
| Facility | | $15,488.17 | $25,118.86 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,902.95 / $45,708.82 / $56,234.13
| Facility | | $30,902.95 | $45,708.82 | $56,234.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,512.09 / $29,512.09 / $29,512.09
| Facility | | $29,512.09 | $29,512.09 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $23,442.29 / $30,902.95
| Facility | | $15,848.93 | $23,442.29 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,512.09 / $29,512.09 / $29,512.09
| Facility | | $29,512.09 | $29,512.09 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $20,892.96 / $33,884.42
| Facility | | $12,882.50 | $20,892.96 | $33,884.42 |