- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,850.20 / $36,936.60 / $43,197.50
| Facility | | $23,850.20 | $36,936.60 | $43,197.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,803.39 / $36,168.51 / $50,825.14
| Facility | | $23,803.39 | $36,168.51 | $50,825.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,023.89 / $33,985.19 / $47,544.74
| Facility | | $22,023.89 | $33,985.19 | $47,544.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,787.12 / $31,803.00 / $42,092.00
| Facility | | $20,787.12 | $31,803.00 | $42,092.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $28,973.00 / $56,652.64
| Facility | | $5,274.00 | $28,973.00 | $56,652.64 |