- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,786.70 / $39,116.50 / $51,412.50
| Facility | | $26,786.70 | $39,116.50 | $51,412.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,033.75 / $52,816.46 / $87,780.29
| Facility | | $28,033.75 | $52,816.46 | $87,780.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,211.58 / $37,416.82 / $65,763.12
| Facility | | $27,211.58 | $37,416.82 | $65,763.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,693.97 / $43,848.52 / $64,022.41
| Facility | | $33,693.97 | $43,848.52 | $64,022.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,693.97 / $40,763.04 / $64,022.41
| Facility | | $33,693.97 | $40,763.04 | $64,022.41 |