- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,547.09 / $33,884.42 / $38,018.94
| Facility | | $24,547.09 | $33,884.42 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $25,703.96 / $25,703.96
| Facility | | $25,703.96 | $25,703.96 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $31,622.78 / $41,686.94
| Facility | | $17,782.79 | $31,622.78 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $24,547.09 / $60,255.96
| Facility | | $16,218.10 | $24,547.09 | $60,255.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $23,988.33 / $35,481.34
| Facility | | $15,135.61 | $23,988.33 | $35,481.34 |