- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,017.90 / $30,722.90 / $42,512.50
| Facility | | $19,017.90 | $30,722.90 | $42,512.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,908.73 / $24,908.73 / $24,908.73
| Facility | | $24,908.73 | $24,908.73 | $24,908.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,633.58 / $31,460.03 / $47,662.62
| Facility | | $19,633.58 | $31,460.03 | $47,662.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,350.63 / $28,407.47 / $44,003.26
| Facility | | $18,350.63 | $28,407.47 | $44,003.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,701.41 / $27,300.77 / $41,642.30
| Facility | | $16,701.41 | $27,300.77 | $41,642.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,961.03 / $33,608.96 / $47,253.92
| Facility | | $8,961.03 | $33,608.96 | $47,253.92 |