- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,542.29 / $41,686.94 / $58,884.37
| Facility | | $27,542.29 | $41,686.94 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $34,673.69 / $58,884.37
| Facility | | $12,882.50 | $34,673.69 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,547.09 / $34,673.69 / $58,884.37
| Facility | | $24,547.09 | $34,673.69 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,902.95 / $38,018.94 / $54,954.09
| Facility | | $30,902.95 | $38,018.94 | $54,954.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,498.45 / $37,153.52 / $53,703.18
| Facility | | $19,498.45 | $37,153.52 | $53,703.18 |