- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $36,307.81 / $58,884.37
| Facility | | $20,417.38 | $36,307.81 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $34,673.69 / $57,543.99
| Facility | | $12,882.50 | $34,673.69 | $57,543.99 |
- 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
- $30,199.52 / $38,904.51 / $54,954.09
| Facility | | $30,199.52 | $38,904.51 | $54,954.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $36,307.81 / $56,234.13
| Facility | | $19,054.61 | $36,307.81 | $56,234.13 |