- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,063.80 / $19,051.40 / $30,926.40
| Facility | | $13,063.80 | $19,051.40 | $30,926.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,689.51 / $55,002.93 / $70,516.58
| Facility | | $38,689.51 | $55,002.93 | $70,516.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,339.97 / $29,658.40 / $37,512.51
| Facility | | $15,339.97 | $29,658.40 | $37,512.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,629.90 / $20,488.40 / $32,761.80
| Facility | | $13,629.90 | $20,488.40 | $32,761.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,940.01 / $27,257.62 / $41,412.25
| Facility | | $15,940.01 | $27,257.62 | $41,412.25 |