- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,338.40 / $33,274.69 / $42,399.20
| Facility | | $21,338.40 | $33,274.69 | $42,399.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48,406.86 / $48,406.86 / $48,406.86
| Facility | | $48,406.86 | $48,406.86 | $48,406.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,808.62 / $34,085.64 / $40,148.46
| Facility | | $17,808.62 | $34,085.64 | $40,148.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,162.11 / $34,568.23 / $48,427.56
| Facility | | $18,162.11 | $34,568.23 | $48,427.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,848.74 / $37,709.14 / $48,427.56
| Facility | | $32,848.74 | $37,709.14 | $48,427.56 |