- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,343.10 / $27,047.90 / $27,047.90
| Facility | | $24,343.10 | $27,047.90 | $27,047.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,070.91 / $18,070.91 / $18,070.91
| Facility | | $18,070.91 | $18,070.91 | $18,070.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,622.25 / $26,742.58 / $55,076.41
| Facility | | $16,622.25 | $26,742.58 | $55,076.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,880.48 / $30,110.08 / $46,802.29
| Facility | | $16,880.48 | $30,110.08 | $46,802.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,027.00 / $39,508.83 / $63,465.52
| Facility | | $15,027.00 | $39,508.83 | $63,465.52 |