- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,407.90 / $25,758.80 / $44,980.10
| Facility | | $19,407.90 | $25,758.80 | $44,980.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,684.37 / $15,684.37 / $20,394.47
| Facility | | $15,684.37 | $15,684.37 | $20,394.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $22,215.20 / $43,802.46
| Facility | | $5,939.30 | $22,215.20 | $43,802.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,743.61 / $26,110.88 / $40,159.35
| Facility | | $16,743.61 | $26,110.88 | $40,159.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $26,435.00 / $45,509.06
| Facility | | $3,496.00 | $26,435.00 | $45,509.06 |