- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,915.35 / $38,018.94 / $48,977.88
| Facility | | $26,915.35 | $38,018.94 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $33,113.11 / $46,773.51
| Facility | | $20,892.96 | $33,113.11 | $46,773.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $39,810.72 / $56,234.13
| Facility | | $20,892.96 | $39,810.72 | $56,234.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $33,884.42 / $41,686.94
| Facility | | $20,892.96 | $33,884.42 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $39,810.72 / $56,234.13
| Facility | | $19,054.61 | $39,810.72 | $56,234.13 |