- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $30,199.52 / $42,657.95
| Facility | | $18,620.87 | $30,199.52 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $28,183.83 / $28,183.83
| Facility | | $28,183.83 | $28,183.83 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,387.21 / $33,884.42 / $45,708.82
| Facility | | $22,387.21 | $33,884.42 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $28,840.32 / $46,773.51
| Facility | | $19,054.61 | $28,840.32 | $46,773.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $26,915.35 / $46,773.51
| Facility | | $4,365.16 | $26,915.35 | $46,773.51 |