- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $38,904.51 / $50,118.72
| Facility | | $28,183.83 | $38,904.51 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $40,738.03 / $47,863.01
| Facility | | $23,988.33 | $40,738.03 | $47,863.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $40,738.03 / $57,543.99
| Facility | | $21,379.62 | $40,738.03 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,673.69 / $34,673.69 / $45,708.82
| Facility | | $34,673.69 | $34,673.69 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,498.45 / $40,738.03 / $57,543.99
| Facility | | $19,498.45 | $40,738.03 | $57,543.99 |