- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $19,952.62 / $32,359.37
| Facility | | $19,952.62 | $19,952.62 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,915.35 / $35,481.34 / $53,703.18
| Facility | | $26,915.35 | $35,481.34 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $27,542.29 / $37,153.52
| Facility | | $14,791.08 | $27,542.29 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $17,782.79 / $30,199.52
| Facility | | $17,782.79 | $17,782.79 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,481.34 / $35,481.34 / $61,659.50
| Facility | | $35,481.34 | $35,481.34 | $61,659.50 |