- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,834.68 / $25,310.90 / $42,022.10
| Facility | | $16,834.68 | $25,310.90 | $42,022.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,769.20 / $25,121.25 / $42,555.91
| Facility | | $16,769.20 | $25,121.25 | $42,555.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,817.18 / $26,996.97 / $38,818.35
| Facility | | $21,817.18 | $26,996.97 | $38,818.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,043.87 / $25,933.67 / $74,985.21
| Facility | | $13,043.87 | $25,933.67 | $74,985.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,043.87 / $25,877.25 / $36,369.19
| Facility | | $13,043.87 | $25,877.25 | $36,369.19 |