- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $29,512.09 / $48,977.88
| Facility | | $17,782.79 | $29,512.09 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,307.81 / $53,703.18 / $70,794.58
| Facility | | $36,307.81 | $53,703.18 | $70,794.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,673.69 / $43,651.58 / $60,255.96
| Facility | | $34,673.69 | $43,651.58 | $60,255.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,302.68 / $43,651.58 / $58,884.37
| Facility | | $26,302.68 | $43,651.58 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,302.68 / $43,651.58 / $61,659.50
| Facility | | $26,302.68 | $43,651.58 | $61,659.50 |