- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $27,542.29 / $36,307.81
| Facility | | $16,982.44 | $27,542.29 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $33,113.11 / $41,686.94
| Facility | | $22,908.68 | $33,113.11 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,113.11 / $33,113.11 / $33,113.11
| Facility | | $33,113.11 | $33,113.11 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $25,118.86 / $34,673.69
| Facility | | $17,378.01 | $25,118.86 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,113.11 / $33,113.11 / $33,113.11
| Facility | | $33,113.11 | $33,113.11 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $23,988.33 / $38,018.94
| Facility | | $15,135.61 | $23,988.33 | $38,018.94 |