- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $26,302.68 / $37,153.52
| Facility | | $11,220.18 | $26,302.68 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,542.29 / $27,542.29 / $27,542.29
| Facility | | $27,542.29 | $27,542.29 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,387.21 / $34,673.69 / $54,954.09
| Facility | | $22,387.21 | $34,673.69 | $54,954.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $26,302.68 / $54,954.09
| Facility | | $19,054.61 | $26,302.68 | $54,954.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $21,877.62 / $47,863.01
| Facility | | $16,595.87 | $21,877.62 | $47,863.01 |