- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $33,113.11 / $51,286.14
| Facility | | $25,703.96 | $33,113.11 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $21,877.62 / $38,018.94
| Facility | | $21,877.62 | $21,877.62 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $31,622.78 / $48,977.88
| Facility | | $6,918.31 | $31,622.78 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $26,302.68 / $48,977.88
| Facility | | $19,054.61 | $26,302.68 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $21,877.62 / $45,708.82
| Facility | | $3,311.31 | $21,877.62 | $45,708.82 |