- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,399.70 / $29,332.90 / $29,332.90
| Facility | | $26,399.70 | $29,332.90 | $29,332.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,611.32 / $19,418.84 / $22,809.55
| Facility | | $18,611.32 | $19,418.84 | $22,809.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,985.02 / $26,220.48 / $47,610.54
| Facility | | $15,985.02 | $26,220.48 | $47,610.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,247.22 / $35,390.00 / $52,010.02
| Facility | | $24,247.22 | $35,390.00 | $52,010.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,593.45 / $43,822.72 / $56,582.46
| Facility | | $24,593.45 | $43,822.72 | $56,582.46 |