- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,882.22 / $23,821.45 / $23,821.45
| Facility | | $20,882.22 | $23,821.45 | $23,821.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,194.46 / $26,209.60 / $48,224.41
| Facility | | $16,194.46 | $26,209.60 | $48,224.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,646.69 / $31,098.00 / $45,286.98
| Facility | | $23,646.69 | $31,098.00 | $45,286.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,061.52 / $31,736.01 / $46,623.85
| Facility | | $21,061.52 | $31,736.01 | $46,623.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,846.28 / $25,846.28 / $44,979.65
| Facility | | $25,846.28 | $25,846.28 | $44,979.65 |