- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $30,902.95 / $40,738.03
| Facility | | $19,054.61 | $30,902.95 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $40,738.03 / $50,118.72
| Facility | | $28,183.83 | $40,738.03 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,307.81 / $36,307.81 / $36,307.81
| Facility | | $36,307.81 | $36,307.81 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,498.45 / $28,183.83 / $38,018.94
| Facility | | $19,498.45 | $28,183.83 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,307.81 / $36,307.81 / $36,307.81
| Facility | | $36,307.81 | $36,307.81 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $25,703.96 / $41,686.94
| Facility | | $16,982.44 | $25,703.96 | $41,686.94 |