- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,803.40 / $35,510.60 / $57,719.60
| Facility | | $20,803.40 | $35,510.60 | $57,719.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,870.21 / $25,870.21 / $30,460.82
| Facility | | $25,870.21 | $25,870.21 | $30,460.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,838.79 / $28,214.93 / $44,511.78
| Facility | | $17,838.79 | $28,214.93 | $44,511.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,228.56 / $26,862.11 / $51,463.28
| Facility | | $15,228.56 | $26,862.11 | $51,463.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,673.91 / $32,108.11 / $42,743.23
| Facility | | $20,673.91 | $32,108.11 | $42,743.23 |