- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,293.00 / $23,792.60 / $31,271.70
| Facility | | $16,293.00 | $23,792.60 | $31,271.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,925.11 / $29,753.20 / $50,323.53
| Facility | | $10,925.11 | $29,753.20 | $50,323.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,149.14 / $24,008.51 / $43,595.36
| Facility | | $17,149.14 | $24,008.51 | $43,595.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,494.39 / $26,670.90 / $38,941.68
| Facility | | $20,494.39 | $26,670.90 | $38,941.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,494.39 / $24,794.15 / $38,941.68
| Facility | | $20,494.39 | $24,794.15 | $38,941.68 |