- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,111.80 / $27,210.20 / $55,298.30
| Facility | | $21,111.80 | $27,210.20 | $55,298.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,521.56 / $30,382.96 / $31,071.60
| Facility | | $21,521.56 | $30,382.96 | $31,071.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,983.34 / $26,303.06 / $30,071.20
| Facility | | $20,983.34 | $26,303.06 | $30,071.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,851.68 / $29,829.26 / $38,794.24
| Facility | | $16,851.68 | $29,829.26 | $38,794.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,749.79 / $36,613.24 / $37,132.19
| Facility | | $24,749.79 | $36,613.24 | $37,132.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $25,881.49 / $38,104.86
| Facility | | $1,518.00 | $25,881.49 | $38,104.86 |