- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $26,302.68 / $34,673.69
| Facility | | $16,218.10 | $26,302.68 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $40,738.03 / $50,118.72
| Facility | | $28,183.83 | $40,738.03 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,622.78 / $31,622.78 / $31,622.78
| Facility | | $31,622.78 | $31,622.78 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $24,547.09 / $33,113.11
| Facility | | $16,982.44 | $24,547.09 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,622.78 / $31,622.78 / $31,622.78
| Facility | | $31,622.78 | $31,622.78 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $22,387.21 / $36,307.81
| Facility | | $14,791.08 | $22,387.21 | $36,307.81 |