- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48,977.88 / $48,977.88 / $48,977.88
| Facility | | $48,977.88 | $48,977.88 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,840.32 / $40,738.03 / $61,659.50
| Facility | | $28,840.32 | $40,738.03 | $61,659.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $43,651.58 / $56,234.13
| Facility | | $23,988.33 | $43,651.58 | $56,234.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,359.37 / $47,863.01 / $50,118.72
| Facility | | $32,359.37 | $47,863.01 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,840.32 / $32,359.37 / $57,543.99
| Facility | | $28,840.32 | $32,359.37 | $57,543.99 |