- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,199.52 / $44,668.36 / $57,543.99
| Facility | | $30,199.52 | $44,668.36 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $19,054.61 / $40,738.03
| Facility | | $9,772.37 | $19,054.61 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $21,877.62 / $40,738.03
| Facility | | $15,848.93 | $21,877.62 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $21,877.62 / $40,738.03
| Facility | | $15,848.93 | $21,877.62 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $27,542.29 / $44,668.36
| Facility | | $5,370.32 | $27,542.29 | $44,668.36 |