- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,509.20 / $30,917.80 / $51,330.80
| Facility | | $19,509.20 | $30,917.80 | $51,330.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,670.81 / $29,670.81 / $43,054.09
| Facility | | $29,670.81 | $29,670.81 | $43,054.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,519.77 / $27,743.71 / $46,998.42
| Facility | | $18,519.77 | $27,743.71 | $46,998.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,650.14 / $32,977.36 / $47,417.42
| Facility | | $26,650.14 | $32,977.36 | $47,417.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,933.36 / $31,678.52 / $82,813.08
| Facility | | $15,933.36 | $31,678.52 | $82,813.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,566.88 / $28,850.28 / $43,858.48
| Facility | | $16,566.88 | $28,850.28 | $43,858.48 |