- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,497.30 / $25,129.30 / $51,069.40
| Facility | | $19,497.30 | $25,129.30 | $51,069.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,557.40 / $25,511.78 / $28,426.87
| Facility | | $17,557.40 | $25,511.78 | $28,426.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,410.37 / $25,584.83 / $29,250.07
| Facility | | $20,410.37 | $25,584.83 | $29,250.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,562.98 / $27,548.10 / $35,827.49
| Facility | | $15,562.98 | $27,548.10 | $35,827.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,338.55 / $29,338.55 / $32,690.90
| Facility | | $29,338.55 | $29,338.55 | $32,690.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $23,902.23 / $35,190.83
| Facility | | $1,518.00 | $23,902.23 | $35,190.83 |