- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $34,673.69 / $46,773.51
| Facility | | $18,197.01 | $34,673.69 | $46,773.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $28,840.32 / $46,773.51
| Facility | | $19,054.61 | $28,840.32 | $46,773.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $33,884.42 / $50,118.72
| Facility | | $17,782.79 | $33,884.42 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $26,915.35 / $50,118.72
| Facility | | $7,943.28 | $26,915.35 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $26,915.35 / $52,480.75
| Facility | | $6,456.54 | $26,915.35 | $52,480.75 |