- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,302.68 / $38,018.94 / $57,543.99
| Facility | | $26,302.68 | $38,018.94 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $31,622.78 / $48,977.88
| Facility | | $21,877.62 | $31,622.78 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $31,622.78 / $56,234.13
| Facility | | $9,549.93 | $31,622.78 | $56,234.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $31,622.78 / $52,480.75
| Facility | | $7,585.78 | $31,622.78 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $24,547.09 / $41,686.94
| Facility | | $15,488.17 | $24,547.09 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $39,810.72 / $56,234.13
| Facility | | $9,772.37 | $39,810.72 | $56,234.13 |