- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $39,810.72 / $57,543.99
| Facility | | $17,782.79 | $39,810.72 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $20,417.38 / $47,863.01
| Facility | | $14,454.40 | $20,417.38 | $47,863.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,915.35 / $38,904.51 / $52,480.75
| Facility | | $26,915.35 | $38,904.51 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $12,589.25 / $12,589.25
| Facility | | $12,589.25 | $12,589.25 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $22,387.21 / $44,668.36
| Facility | | $10,964.78 | $22,387.21 | $44,668.36 |