- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,844.00 / $35,305.60 / $57,011.60
| Facility | | $21,844.00 | $35,305.60 | $57,011.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,912.71 / $28,693.83 / $34,152.25
| Facility | | $19,912.71 | $28,693.83 | $34,152.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,219.08 / $30,159.25 / $43,965.76
| Facility | | $18,219.08 | $30,159.25 | $43,965.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,371.25 / $30,080.21 / $56,064.13
| Facility | | $16,371.25 | $30,080.21 | $56,064.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,420.31 / $31,714.25 / $42,218.91
| Facility | | $20,420.31 | $31,714.25 | $42,218.91 |