- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,588.30 / $30,402.10 / $61,785.20
| Facility | | $23,588.30 | $30,402.10 | $61,785.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,320.74 / $31,468.03 / $34,865.79
| Facility | | $28,320.74 | $31,468.03 | $34,865.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,009.68 / $28,843.12 / $32,975.14
| Facility | | $23,009.68 | $28,843.12 | $32,975.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,828.52 / $33,328.46 / $43,345.11
| Facility | | $18,828.52 | $33,328.46 | $43,345.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,352.53 / $36,188.23 / $40,095.66
| Facility | | $35,352.53 | $36,188.23 | $40,095.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $28,917.58 / $42,574.85
| Facility | | $1,518.00 | $28,917.58 | $42,574.85 |