- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,386.10 / $23,762.30 / $23,762.30
| Facility | | $21,386.10 | $23,762.30 | $23,762.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,857.14 / $16,857.14 / $16,857.14
| Facility | | $16,857.14 | $16,857.14 | $16,857.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,429.94 / $26,358.66 / $42,404.85
| Facility | | $13,429.94 | $26,358.66 | $42,404.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,642.43 / $27,831.00 / $41,117.12
| Facility | | $19,642.43 | $27,831.00 | $41,117.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,698.29 / $35,500.33 / $45,836.87
| Facility | | $19,698.29 | $35,500.33 | $45,836.87 |