- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,101.30 / $22,117.10 / $38,919.69
| Facility | | $13,101.30 | $22,117.10 | $38,919.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,533.28 / $33,261.33 / $54,995.75
| Facility | | $22,533.28 | $33,261.33 | $54,995.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,917.66 / $20,147.20 / $28,150.20
| Facility | | $11,917.66 | $20,147.20 | $28,150.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,409.85 / $40,409.85 / $47,424.39
| Facility | | $40,409.85 | $40,409.85 | $47,424.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $19,274.87 / $27,531.95
| Facility | | $1,787.00 | $19,274.87 | $27,531.95 |