- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $40,738.03 / $43,651.58
| Facility | | $23,988.33 | $40,738.03 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,915.35 / $39,810.72 / $56,234.13
| Facility | | $26,915.35 | $39,810.72 | $56,234.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,387.21 / $34,673.69 / $48,977.88
| Facility | | $22,387.21 | $34,673.69 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $30,199.52 / $43,651.58
| Facility | | $20,892.96 | $30,199.52 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $38,018.94 / $57,543.99
| Facility | | $4,073.80 | $38,018.94 | $57,543.99 |