- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,600.60 / $36,550.10 / $42,745.50
| Facility | | $23,600.60 | $36,550.10 | $42,745.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,543.69 / $35,640.83 / $50,270.62
| Facility | | $23,543.69 | $35,640.83 | $50,270.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,793.41 / $33,629.55 / $47,047.21
| Facility | | $21,793.41 | $33,629.55 | $47,047.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,832.00 / $32,535.00 / $44,078.00
| Facility | | $20,832.00 | $32,535.00 | $44,078.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $36,031.74 / $56,194.75
| Facility | | $5,274.00 | $36,031.74 | $56,194.75 |