- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,307.70 / $31,250.50 / $50,795.20
| Facility | | $18,307.70 | $31,250.50 | $50,795.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,861.05 / $32,726.09 / $33,225.43
| Facility | | $28,861.05 | $32,726.09 | $33,225.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,698.72 / $24,830.06 / $39,171.83
| Facility | | $15,698.72 | $24,830.06 | $39,171.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,350.10 / $22,297.58 / $42,599.41
| Facility | | $12,350.10 | $22,297.58 | $42,599.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,301.68 / $28,256.19 / $37,615.44
| Facility | | $18,301.68 | $28,256.19 | $37,615.44 |