- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,212.60 / $28,930.90 / $48,846.90
| Facility | | $13,212.60 | $28,930.90 | $48,846.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,262.50 / $47,224.97 / $61,088.56
| Facility | | $28,262.50 | $47,224.97 | $61,088.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,840.98 / $41,241.47 / $60,540.17
| Facility | | $28,840.98 | $41,241.47 | $60,540.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,222.85 / $40,780.22 / $85,517.41
| Facility | | $21,222.85 | $40,780.22 | $85,517.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,840.98 / $44,902.08 / $60,873.93
| Facility | | $28,840.98 | $44,902.08 | $60,873.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,028.28 / $34,779.17 / $57,019.91
| Facility | | $13,028.28 | $34,779.17 | $57,019.91 |