- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $26,915.35 / $43,651.58
| Facility | | $17,782.79 | $26,915.35 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,884.42 / $47,863.01 / $64,565.42
| Facility | | $33,884.42 | $47,863.01 | $64,565.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,359.37 / $38,904.51 / $54,954.09
| Facility | | $32,359.37 | $38,904.51 | $54,954.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $38,904.51 / $52,480.75
| Facility | | $23,988.33 | $38,904.51 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $36,307.81 / $54,954.09
| Facility | | $23,988.33 | $36,307.81 | $54,954.09 |