- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,902.95 / $41,686.94 / $58,884.37
| Facility | | $30,902.95 | $41,686.94 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,840.32 / $41,686.94 / $48,977.88
| Facility | | $28,840.32 | $41,686.94 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,542.29 / $39,810.72 / $53,703.18
| Facility | | $27,542.29 | $39,810.72 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $21,877.62 / $21,877.62
| Facility | | $21,877.62 | $21,877.62 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $40,738.03 / $54,954.09
| Facility | | $10,964.78 | $40,738.03 | $54,954.09 |