- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,751.80 / $36,082.60 / $48,420.00
| Facility | | $21,751.80 | $36,082.60 | $48,420.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,092.24 / $30,046.91 / $39,069.76
| Facility | | $20,092.24 | $30,046.91 | $39,069.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,014.28 / $30,827.73 / $47,667.05
| Facility | | $17,014.28 | $30,827.73 | $47,667.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,861.16 / $29,052.00 / $66,627.86
| Facility | | $17,861.16 | $29,052.00 | $66,627.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,206.02 / $28,618.16 / $41,040.79
| Facility | | $21,206.02 | $28,618.16 | $41,040.79 |