- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $31,622.78 / $56,234.13
| Facility | | $22,908.68 | $31,622.78 | $56,234.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $25,703.96 / $38,018.94
| Facility | | $19,054.61 | $25,703.96 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,302.68 / $30,199.52 / $54,954.09
| Facility | | $26,302.68 | $30,199.52 | $54,954.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $30,199.52 / $50,118.72
| Facility | | $12,882.50 | $30,199.52 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $30,199.52 / $41,686.94
| Facility | | $19,952.62 | $30,199.52 | $41,686.94 |