- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $30,902.95 / $58,884.37
| Facility | | $12,589.25 | $30,902.95 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,359.37 / $42,657.95 / $54,954.09
| Facility | | $32,359.37 | $42,657.95 | $54,954.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,302.68 / $41,686.94 / $53,703.18
| Facility | | $26,302.68 | $41,686.94 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $37,153.52 / $93,325.43
| Facility | | $21,379.62 | $37,153.52 | $93,325.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $32,359.37 / $52,480.75
| Facility | | $9,332.54 | $32,359.37 | $52,480.75 |