- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,302.68 / $31,622.78 / $38,018.94
| Facility | | $26,302.68 | $31,622.78 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $28,840.32 / $45,708.82
| Facility | | $28,183.83 | $28,840.32 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Facility | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,118.86 / $32,359.37 / $51,286.14
| Facility | | $25,118.86 | $32,359.37 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $42,657.95 / $42,657.95
| Facility | | $20,417.38 | $42,657.95 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,302.68 / $36,307.81 / $53,703.18
| Facility | | $26,302.68 | $36,307.81 | $53,703.18 |