- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,442.29 / $39,810.72 / $42,657.95
| Facility | | $23,442.29 | $39,810.72 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,302.68 / $38,904.51 / $53,703.18
| Facility | | $26,302.68 | $38,904.51 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $33,113.11 / $47,863.01
| Facility | | $16,218.10 | $33,113.11 | $47,863.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $30,902.95 / $42,657.95
| Facility | | $15,488.17 | $30,902.95 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $37,153.52 / $56,234.13
| Facility | | $4,073.80 | $37,153.52 | $56,234.13 |