- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $30,902.95 / $58,884.37
| Facility | | $19,952.62 | $30,902.95 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $28,183.83 / $30,902.95
| Facility | | $11,220.18 | $28,183.83 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $26,302.68 / $42,657.95
| Facility | | $17,378.01 | $26,302.68 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $22,387.21 / $43,651.58
| Facility | | $11,481.54 | $22,387.21 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $27,542.29 / $38,904.51
| Facility | | $6,606.93 | $27,542.29 | $38,904.51 |