- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,812.30 / $32,013.70 / $32,013.70
| Facility | | $28,812.30 | $32,013.70 | $32,013.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,523.86 / $15,523.86 / $25,973.42
| Facility | | $15,523.86 | $15,523.86 | $25,973.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,647.57 / $20,711.48 / $40,262.74
| Facility | | $11,647.57 | $20,711.48 | $40,262.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,979.62 / $35,248.11 / $55,394.87
| Facility | | $19,979.62 | $35,248.11 | $55,394.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $47,827.67 / $61,753.53
| Facility | | $6,965.00 | $47,827.67 | $61,753.53 |