- 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
- $25,703.96 / $33,884.42 / $50,118.72
| Facility | | $25,703.96 | $33,884.42 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $26,302.68 / $34,673.69
| Facility | | $14,125.38 | $26,302.68 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $16,982.44 / $28,183.83
| Facility | | $16,982.44 | $16,982.44 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,512.09 / $29,512.09 / $58,884.37
| Facility | | $29,512.09 | $29,512.09 | $58,884.37 |