- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,062.20 / $35,716.40 / $41,770.40
| Facility | | $23,062.20 | $35,716.40 | $41,770.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,274.16 / $33,719.00 / $47,559.92
| Facility | | $22,274.16 | $33,719.00 | $47,559.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,296.30 / $32,862.44 / $45,442.41
| Facility | | $21,296.30 | $32,862.44 | $45,442.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,055.56 / $29,539.00 / $42,704.00
| Facility | | $20,055.56 | $29,539.00 | $42,704.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $41,259.39 / $54,912.93
| Facility | | $5,274.00 | $41,259.39 | $54,912.93 |