- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,233.20 / $26,801.70 / $46,892.80
| Facility | | $20,233.20 | $26,801.70 | $46,892.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,094.86 / $21,189.98 / $29,301.70
| Facility | | $16,094.86 | $21,189.98 | $29,301.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $23,084.92 / $45,082.85
| Facility | | $5,939.30 | $23,084.92 | $45,082.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,255.81 / $27,459.74 / $41,867.10
| Facility | | $18,255.81 | $27,459.74 | $41,867.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $27,620.44 / $47,444.31
| Facility | | $3,496.00 | $27,620.44 | $47,444.31 |