- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,902.95 / $43,651.58 / $54,954.09
| Facility | | $30,902.95 | $43,651.58 | $54,954.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $38,018.94 / $52,480.75
| Facility | | $23,988.33 | $38,018.94 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $45,708.82 / $63,095.73
| Facility | | $23,988.33 | $45,708.82 | $63,095.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $41,686.94 / $52,480.75
| Facility | | $23,988.33 | $41,686.94 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $45,708.82 / $63,095.73
| Facility | | $21,379.62 | $45,708.82 | $63,095.73 |