- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $23,988.33 / $30,199.52
| Facility | | $10,715.19 | $23,988.33 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $22,908.68 / $26,302.68
| Facility | | $22,908.68 | $22,908.68 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $33,884.42 / $53,703.18
| Facility | | $21,379.62 | $33,884.42 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $24,547.09 / $52,480.75
| Facility | | $16,982.44 | $24,547.09 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $21,379.62 / $45,708.82
| Facility | | $15,848.93 | $21,379.62 | $45,708.82 |