- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,875.20 / $34,305.69 / $34,305.69
| Facility | | $30,875.20 | $34,305.69 | $34,305.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,885.18 / $30,369.68 / $49,430.68
| Facility | | $17,885.18 | $30,369.68 | $49,430.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,437.19 / $21,987.84 / $40,729.51
| Facility | | $12,437.19 | $21,987.84 | $40,729.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,410.08 / $37,771.73 / $59,360.91
| Facility | | $21,410.08 | $37,771.73 | $59,360.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $51,251.93 / $66,174.82
| Facility | | $6,965.00 | $51,251.93 | $66,174.82 |