- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,746.59 / $24,422.10 / $39,644.80
| Facility | | $16,746.59 | $24,422.10 | $39,644.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,264.54 / $45,868.87 / $58,806.24
| Facility | | $32,264.54 | $45,868.87 | $58,806.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,664.43 / $38,525.89 / $48,019.52
| Facility | | $19,664.43 | $38,525.89 | $48,019.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,472.30 / $26,264.30 / $41,997.70
| Facility | | $17,472.30 | $26,264.30 | $41,997.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,433.64 / $34,941.78 / $53,086.72
| Facility | | $20,433.64 | $34,941.78 | $53,086.72 |