- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,547.70 / $23,941.80 / $23,941.80
| Facility | | $21,547.70 | $23,941.80 | $23,941.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,171.21 / $19,915.50 / $27,811.50
| Facility | | $11,171.21 | $19,915.50 | $27,811.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,795.03 / $17,548.45 / $38,643.28
| Facility | | $10,795.03 | $17,548.45 | $38,643.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,932.33 / $26,554.00 / $41,427.78
| Facility | | $18,932.33 | $26,554.00 | $41,427.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $35,768.54 / $46,183.18
| Facility | | $6,965.00 | $35,768.54 | $46,183.18 |