- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,930.00 / $33,484.69 / $44,010.40
| Facility | | $22,930.00 | $33,484.69 | $44,010.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,689.68 / $34,558.78 / $58,451.52
| Facility | | $12,689.68 | $34,558.78 | $58,451.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,134.92 / $33,788.48 / $60,269.11
| Facility | | $24,134.92 | $33,788.48 | $60,269.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,842.87 / $37,535.41 / $54,804.75
| Facility | | $28,842.87 | $37,535.41 | $54,804.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,842.87 / $34,894.16 / $54,804.75
| Facility | | $28,842.87 | $34,894.16 | $54,804.75 |