- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,531.20 / $36,442.60 / $42,619.80
| Facility | | $23,531.20 | $36,442.60 | $42,619.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,758.81 / $35,966.48 / $50,729.94
| Facility | | $23,758.81 | $35,966.48 | $50,729.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,729.34 / $33,482.00 / $46,908.88
| Facility | | $21,729.34 | $33,482.00 | $46,908.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,832.00 / $33,692.00 / $46,862.00
| Facility | | $20,832.00 | $33,692.00 | $46,862.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $38,367.33 / $56,029.52
| Facility | | $5,274.00 | $38,367.33 | $56,029.52 |