- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,823.00 / $26,026.90 / $34,208.30
| Facility | | $17,823.00 | $26,026.90 | $34,208.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,381.88 / $14,656.89 / $24,790.15
| Facility | | $5,381.88 | $14,656.89 | $24,790.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,759.54 / $26,263.03 / $46,845.84
| Facility | | $18,759.54 | $26,263.03 | $46,845.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,418.92 / $29,175.44 / $42,598.52
| Facility | | $22,418.92 | $29,175.44 | $42,598.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,418.92 / $27,122.46 / $42,598.52
| Facility | | $22,418.92 | $27,122.46 | $42,598.52 |