- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,129.20 / $26,663.90 / $46,651.70
| Facility | | $20,129.20 | $26,663.90 | $46,651.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,177.64 / $21,133.26 / $32,603.23
| Facility | | $15,177.64 | $21,133.26 | $32,603.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $22,981.92 / $44,881.69
| Facility | | $5,939.30 | $22,981.92 | $44,881.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,930.00 / $25,581.76 / $41,651.78
| Facility | | $15,930.00 | $25,581.76 | $41,651.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $27,478.39 / $47,200.30
| Facility | | $3,496.00 | $27,478.39 | $47,200.30 |