- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $38,018.94 / $48,977.88
| Facility | | $25,703.96 | $38,018.94 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $16,218.10 / $34,673.69
| Facility | | $8,709.64 | $16,218.10 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $18,620.87 / $34,673.69
| Facility | | $13,489.63 | $18,620.87 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $18,620.87 / $34,673.69
| Facility | | $13,489.63 | $18,620.87 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $23,442.29 / $38,018.94
| Facility | | $5,370.32 | $23,442.29 | $38,018.94 |