- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $39,810.72 / $42,657.95
| Facility | | $28,183.83 | $39,810.72 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,902.95 / $40,738.03 / $61,659.50
| Facility | | $30,902.95 | $40,738.03 | $61,659.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $22,908.68 / $42,657.95
| Facility | | $20,417.38 | $22,908.68 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $30,902.95 / $38,018.94
| Facility | | $20,892.96 | $30,902.95 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $25,118.86 / $81,283.05
| Facility | | $7,244.36 | $25,118.86 | $81,283.05 |