- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,092.10 / $30,316.20 / $43,502.70
| Facility | | $23,092.10 | $30,316.20 | $43,502.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,755.18 / $25,364.74 / $35,966.00
| Facility | | $17,755.18 | $25,364.74 | $35,966.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,183.04 / $29,231.78 / $40,745.74
| Facility | | $19,183.04 | $29,231.78 | $40,745.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,678.00 / $15,678.00 / $15,678.00
| Facility | | $15,678.00 | $15,678.00 | $15,678.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,845.00 / $29,453.73 / $37,891.73
| Facility | | $10,845.00 | $29,453.73 | $37,891.73 |