- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $26,915.35 / $35,481.34
| Facility | | $16,595.87 | $26,915.35 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $31,622.78 / $39,810.72
| Facility | | $21,877.62 | $31,622.78 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,359.37 / $32,359.37 / $32,359.37
| Facility | | $32,359.37 | $32,359.37 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $24,547.09 / $33,884.42
| Facility | | $17,378.01 | $24,547.09 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,359.37 / $32,359.37 / $32,359.37
| Facility | | $32,359.37 | $32,359.37 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $22,908.68 / $37,153.52
| Facility | | $15,135.61 | $22,908.68 | $37,153.52 |