- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,693.20 / $40,961.80 / $54,967.50
| Facility | | $24,693.20 | $40,961.80 | $54,967.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,938.03 / $24,938.03 / $24,938.03
| Facility | | $24,938.03 | $24,938.03 | $24,938.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,888.34 / $35,259.53 / $56,416.61
| Facility | | $20,888.34 | $35,259.53 | $56,416.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,276.41 / $32,980.50 / $75,637.48
| Facility | | $20,276.41 | $32,980.50 | $75,637.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,073.57 / $32,487.99 / $46,836.71
| Facility | | $24,073.57 | $32,487.99 | $46,836.71 |