- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,712.30 / $32,298.30 / $41,155.10
| Facility | | $20,712.30 | $32,298.30 | $41,155.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,157.82 / $27,157.82 / $27,157.82
| Facility | | $27,157.82 | $27,157.82 | $27,157.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,564.29 / $33,085.44 / $38,970.36
| Facility | | $17,564.29 | $33,085.44 | $38,970.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,629.16 / $33,553.87 / $47,006.52
| Facility | | $17,629.16 | $33,553.87 | $47,006.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,884.84 / $36,602.62 / $47,006.52
| Facility | | $31,884.84 | $36,602.62 | $47,006.52 |