- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,709.75 / $28,946.50 / $48,058.10
| Facility | | $20,709.75 | $28,946.50 | $48,058.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,840.22 / $24,840.22 / $37,274.62
| Facility | | $24,840.22 | $24,840.22 | $37,274.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,574.58 / $26,823.44 / $44,599.78
| Facility | | $17,574.58 | $26,823.44 | $44,599.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,951.01 / $30,874.83 / $44,394.24
| Facility | | $24,951.01 | $30,874.83 | $44,394.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,917.50 / $30,996.43 / $49,688.60
| Facility | | $14,917.50 | $30,996.43 | $49,688.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,226.00 / $28,864.65 / $41,062.21
| Facility | | $9,226.00 | $28,864.65 | $41,062.21 |