- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $33,884.42 / $63,095.73
| Facility | | $21,877.62 | $33,884.42 | $63,095.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $28,840.32 / $37,153.52
| Facility | | $11,220.18 | $28,840.32 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $28,840.32 / $45,708.82
| Facility | | $18,620.87 | $28,840.32 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $25,703.96 / $51,286.14
| Facility | | $11,748.98 | $25,703.96 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $32,359.37 / $43,651.58
| Facility | | $17,378.01 | $32,359.37 | $43,651.58 |